MR. MARK GONCHAR (NPI# 1003399403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003399403 |
| Entity Type | Individual |
| Full Name | MR. MARK GONCHAR |
| Credential | LASAC |
| Practice Address |
3095 E Coronado Trl Rimrock AZ 86335-5284 |
| Mailing Address |
Po Box 230 Rimrock AZ 86335-0230 |
| Practice Telephone | 9285671322 |
| Mailing Telephone | 9285671322 |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
13156 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
3095 E CORONADO TRL |
| City | RIMROCK |
| State | AZ |
| Zip Code | 86335-5284 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558845818 | Kathleen Hourihan | Social Worker | 3095 E Coronado Trl, Rimrock, AZ 86335-5284 | 2018-09-21 |
| 1114401916 | Tamara Cy Garden | Counselor | 3095 E Coronado Trl, Rimrock, AZ 86335-5284 | 2018-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442035 | Rodney Kent Courtney | Emergency Medical Technician, Paramedic | 4930 N. Tenderfoot Trail, Rimrock, AZ 86335 | 2020-09-17 |
| 1750726667 | Stevie Stanford | Psychologist | 3095 Coronado Trail, Rimrock, AZ 86335 | 2013-05-06 |
| 1205070786 | Copper Canyon Academy | Residential Treatment Facility, Emotionally Disturbed Children | 3090 Coronado Trail, Rimrock, AZ 86335 | 2009-04-28 |
| 1992855779 | Stacy Ellen Mclaughlin | Massage Therapist | 4030 E Lake Shore Dr, Rimrock, AZ 86335 | 2007-01-12 |
| 1891119822 | Ariella Allaman | Counselor | 3095 Coronado Trail, Rimrock, AZ 86335 | 2014-02-11 |
| 1487091963 | Isabelle Shook | Counselor | 3095 Coronado Trail, Rim Rock, AZ 86335 | 2013-05-24 |
| 1275978900 | Copper Canyon Academy | Residential Treatment Facility, Emotionally Disturbed Children | 3095 Coronado Trail, Lake Montezuma, AZ 86335 | 2013-05-08 |
| 1972849149 | Copper Canyon Academy | Residential Treatment Facility, Emotionally Disturbed Children | 3090 Coronado Trail, Rimrock, AZ 86335 | 2012-12-17 |
| 1528403243 | Kathleen Jo Buri-baca | Counselor | 3095 Coronado Trail, Rimrock, AZ 86335-0230 | 2013-05-08 |
| 1851736565 | D. Taylor Watts | Counselor | 3095 Coronado Trail, Rimrock, AZ 86335-0230 | 2013-05-08 |
| Find all providers in zip 86335 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534946 | Jodie Lynn Gonzalez | Counselor | 20430 W Carla Vista, Buckeye, AZ 85326-4698 | 2020-10-06 |
| 1649885716 | Global Family LLC | Counselor | 4523 N 92nd Ave, Phoenix, AZ 85037-2450 | 2020-09-15 |
| 1891300299 | Roundsville Drug and Alcohol Treatment of Arizona | Counselor | 610 N Bagby Dr, Prescott, AZ 86301-2588 | 2020-09-11 |
| 1982218772 | Bashar Aldeen | Counselor | 3401 W Country Gables Dr, Phoenix, AZ 85053-4756 | 2020-08-31 |
| 1811509581 | Creosote Mental Health Group | Counselor | 4646 N Swan Rd Ste 105, Tucson, AZ 85718-6715 | 2020-08-23 |
| 1316559644 | Pamela Mcrae | Counselor | 17611 W Pershing St, Surprise, AZ 85388-5024 | 2020-08-18 |
| 1508478082 | Tahonna Latreise Surrell | Counselor | 3236 E Chandler Blvd Unit 1034, Phoenix, AZ 85048-7281 | 2020-08-17 |
| 1619588209 | Teri Sebastian | Counselor | 240 S Montezuma St Ste 201e, Prescott, AZ 86303-4712 | 2020-08-16 |
| 1497366314 | Cachora Standifer | Counselor | 6294 S Eagles Talon Pkwy, Tucson, AZ 85757-1639 | 2020-08-13 |
| 1346858883 | Heather Romero | Counselor | 110 W Camelback Rd Ste 200, Phoenix, AZ 85013-2564 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.