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NPI Profile for 4 CORNERS BEHAVIORAL HEALTH PSYCHIATRY LLC in GLENDALE, AZ.
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Case Management |
251B00000X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker | |
Mental Health |
101YM0800X | |||
Psychiatric Residential Treatment Facility |
323P00000X | |||
Psychiatric/Mental Health |
363LP0808X | 50 | Nurse Practitioner |
| NPI Number | 1659107837 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/12/2024 | |
| Last updated | 09/12/2024 - More than a year ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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4 CORNERS BEHAVIORAL HEALTH & PSYCHIATRY LLC