MEDICARE: THE RESOLUTION GROUP, INC.

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	LPC 2079	AZ

General Provider Information

NPI Number	:	1790121820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE RESOLUTION GROUP, INC.

Provider Business Mailing Address
First Line	:	623 W SOUTHERN AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-5029
Country	:	US
Telephone Number	:	480-962-9288
Fax Number	:	480-962-1293

Provider Business Practice Location Address
First Line	:	400 W CAMELBACK RD STE 118
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-2377
Country	:	US
Telephone Number	:	480-962-9288
Fax Number	:	480-962-1293

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	DENISE THOMPSON
Credential	:
Telephone Number	:	480-962-9288

Provider Enumeration Date	:	05/15/2013
Last Update Date	:	05/15/2013

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Directions to “THE RESOLUTION GROUP, INC. ” Practice Location

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