MEDICARE: WHOLENESS 2 PEACE CARE SERVICES

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	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1225984800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLENESS 2 PEACE CARE SERVICES

Provider Business Mailing Address
First Line	:	7725 N 43RD AVE STE 711
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-5772
Country	:	US
Telephone Number	:	623-688-1537
Fax Number	:	602-761-9610

Provider Business Practice Location Address
First Line	:	7725 N 43RD AVE STE 711
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-5772
Country	:	US
Telephone Number	:	623-688-1537
Fax Number	:	602-761-9610

Authorized Official
Title or Position	:	CEO
Name	:	KATRINA BROWN HARRELL
Credential	:	MS,LPC
Telephone Number	:	623-688-1537

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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