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NPI Code Detail

MEDICARE: CAROL LYNNE MCNAB

MEDICARE: CAROL LYNNE MCNAB
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1841544400
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL LYNNE MCNAB
Provider Business Mailing Address
First Line : 4747 N 7TH ST
Second Line : SUITE 100
City : PHOENIX
State : AZ
Zip : 85014-3653
Country : US
Telephone Number : 602-279-7655
Fax Number : 602-264-1806
Provider Business Practice Location Address
First Line : 1840 N 95TH AVE
Second Line : SUITE 146
City : PHOENIX
State : AZ
Zip : 85037-4444
Country : US
Telephone Number : 623-234-9811
Fax Number : 623-234-9815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2012
Last Update Date : 11/05/2012

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Directions to “ CAROL LYNNE MCNAB ” Practice Location

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