MEDICARE: BRITTANY CACHO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LAC-6355T	AZ
2	101YP2500X	Professional Counselor	LPC-21964	AZ

General Provider Information

NPI Number	:	1073123774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY CACHO

Provider Business Mailing Address
First Line	:	11225 N 28TH DR STE D111
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5630
Country	:	US
Telephone Number	:	605-599-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 E MISSOURI AVE STE 340
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2753
Country	:	US
Telephone Number	:	602-932-3336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	09/25/2023

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Directions to “ BRITTANY CACHO ” Practice Location

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