MR. CHARLES BRADY DALTON (NPI# 1073782884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073782884 |
| Entity Type | Individual |
| Full Name | MR. CHARLES BRADY DALTON |
| Credential | PSY.D |
| Practice Address |
4620 N 16th St Suite #e-110 Phoenix AZ 85016-5121 |
| Practice Telephone | 6022642770 |
| Practice Fax Number | 8665341701 |
| Mailing Telephone | 6022642770 |
| Mailing Fax Number | 8665341701 |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2008-02-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 3660 | AZ | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
3660 | AZ | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
3660 | AZ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720004914 | Charles E Dalton Jr. | Nurse Anesthetist, Certified Registered | 830 South Gloster, Tupelo, MS 38801 | 2006-07-14 |
| 1942242037 | Charles H Dalton | Psychologist | 12012 Wickchester Ln, Suite 550, Houston, TX 77079-1229 | 2006-06-12 |
| 1780663229 | Charles Munford Dalton | Urology | 905 University Dr, State College, PA 16801-6626 | 2006-01-12 |
| Street Address |
4620 N 16TH ST SUITE #E-110 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-5121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902978463 | Jill Zwaska | Social Worker | 4620 N 16th St, E110, Phoenix, AZ 85016-5121 | 2006-11-13 |
| 1053657361 | Genesis Medical Practice Management | Psychologist | 4620 N 16th St, E-110, Phoenix, AZ 85016-5121 | 2012-12-14 |
| 1548491350 | Arizona Behavioral Home Health Services LLC | Psychologist | 4620 N 16th St, E-110, Phoenix, AZ 85016-5121 | 2009-07-29 |
| 1679709646 | Jeff C Reed | Counselor | 4620 N 16th St, Suite E-110, Phoenix, AZ 85016-5121 | 2009-06-04 |
| 1891965810 | Elaine M Katzman | Nurse Practitioner | 4620 N 16th St, Suite #e-110, Phoenix, AZ 85016-5121 | 2008-03-05 |
| 1518166453 | Shirvan, Inc. | Durable Medical Equipment & Medical Supplies | 4620 N 16th St, B-209, Phoenix, AZ 85016-5121 | 2007-07-12 |
| 1851510812 | Antonio Dacosta | Social Worker | 4620 N 16th St, Suite #e-110, Phoenix, AZ 85016-5121 | 2007-04-25 |
| 1528184959 | Grace of Serenity Living, Inc | Community/Behavioral Health | 4620 N 16th St, A-101, Phoenix, AZ 85016-5121 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689298838 | Eboni Nicole Morris | Psychologist | 166001 N. 40th St., Suite 210, Phoenix, AZ 85032 | 2020-06-03 |
| 1407319486 | Joan Ledvina Parr | Psychologist | 13 Glenbrook Dr, Phoenix, MD 21131-2007 | 2019-04-08 |
| 1720591365 | Think Psychological and Consulting Services Pllc | Psychologist | 2632 S 83rd Ave Ste 100-481, Phoenix, AZ 85043-7206 | 2017-11-06 |
| 1558880682 | Christine Breuer | Psychologist | 21630 N 19th Ave Ste B17, Phoenix, AZ 85027-2715 | 2017-09-09 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1225584030 | Sojourner Health | Psychologist | 2224 E Fillmore St, Phoenix, AZ 85006-3815 | 2016-08-31 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1982097614 | T. M. Barratt | Psychologist | 3550 N. Central Ave. Suite 1407, Phoenix, AZ 85012 | 2015-03-04 |
| 1003204827 | Melissa Ann Lake | Psychologist | 4552 W Cottontail Rd, Phoenix, AZ 85086-1449 | 2014-12-31 |
| 1699196915 | Deborah Gladding | Psychologist | 36625 N 18th St, Phoenix, AZ 85086-5715 | 2014-01-05 |
| Find all providers in PHOENIX | ||||
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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.