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Contact Information

CREOSOTE MENTAL HEALTH GROUP
4646 N SWAN RD STE 105
TUCSON, AZ85718-6715
 Phone: 520-307-6495
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

101YA0400X
 

Community Health Worker

172V00000X
 

Mental Health

101YM0800X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CREOSOTE MENTAL HEALTH GROUP · (Female)

NPI Number 1811509581
Status Active
Credentials
Entity Individual
Enumeration date 08/23/2020
Last updated 08/23/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ Medicaid 1053801316
  • AZ Other 1053801316 GENERAL
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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