MEDICARE: CARMEL PSYCHOLOGICAL HEALTH, PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	261Q00000X	Clinic/Center
3	1041C0700X	Clinical Social Worker
4	103T00000X	Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720194335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARMEL PSYCHOLOGICAL HEALTH, PC

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:	480-524-0990
Fax Number	:	845-622-5055

Provider Business Practice Location Address
First Line	:	667 STONELEIGH AVE STE 202
Second Line	:
City	:	CARMEL
State	:	NY
Zip	:	10512-2455
Country	:	US
Telephone Number	:	845-279-5908
Fax Number	:	845-622-5055

Authorized Official
Title or Position	:	CHIEF LEGAL OFFICER
Name	:	RYAN PARDO
Credential	:
Telephone Number	:	425-279-8500

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/02/2024

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