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NPI Code Detail

MEDICARE: REDEMPTION COUNSELING CENTER

MEDICARE: REDEMPTION COUNSELING CENTER
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
11041C0700XClinical Social Worker
2106H00000XMarriage & Family Therapist
3101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11588208268OTHERAZNPI NUMBER-NM
21760948046OTHERAZNPI NUMBER-ENB

General Provider Information

NPI Number : 1801431952
Entity Type Code : Organization
Provider Name (Legal Business Name) : REDEMPTION COUNSELING CENTER
Provider Business Mailing Address
First Line : 3009 N WEST ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-3444
Country : US
Telephone Number : 928-719-4009
Fax Number :
Provider Business Practice Location Address
First Line : 3009 N WEST ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-3444
Country : US
Telephone Number : 928-719-4009
Fax Number :
Authorized Official
Title or Position : COUNSELOR
Name : MRS. EMILY BAUERLE
Credential :
Telephone Number : 928-814-8607
Provider Enumeration Date : 11/13/2019
Last Update Date : 11/13/2019

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Directions to “REDEMPTION COUNSELING CENTER ” Practice Location

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