MEDICARE: BATTLECARE COUNSELING SERVICES LLC.

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	103TH0100X	Health Service Psychologist
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1801419494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATTLECARE COUNSELING SERVICES LLC.

Provider Business Mailing Address
First Line	:	2262 E HAZELTINE WAY
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85249-4641
Country	:	US
Telephone Number	:	919-702-3006
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 N PASADENA
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-2706
Country	:	US
Telephone Number	:	480-326-9082
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. JACQUELYN P. BATTLE
Credential	:
Telephone Number	:	919-702-3006

Provider Enumeration Date	:	05/18/2020
Last Update Date	:	05/18/2020

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