SEQUEL TSI OF AZ, LLC (NPI# 1891025524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891025524 |
| Entity Type | Organization |
| Organization Name | SEQUEL TSI OF AZ, LLC |
| Other Organization Name | TRADITIONS WHITERIVER |
| Practice Address |
1109 S. Chief Ave. White Mountain Apache Motel. Whiteriver AZ 85941 |
| Practice Telephone | 9283384927 |
| Practice Fax Number | 9283384742 |
| Mailing Telephone | 9283384927 |
| Mailing Fax Number | 9283384742 |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2009-12-31 |
| Authorized Official Name | CHRIS BANKEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6023352095 |
| Is Organization Subpart | Y |
| Parent Organization Name | SEQUELCARE OF AZ, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Traditions Whiteriver | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790015428 | Sequel Tsi of Az, LLC | Clinic/Center | 75 S. Main St., Suite B, Kentucky Fried Chicken Comples, Tuba City, AZ 86045 | 2009-12-31 |
| 1609106335 | Sequel Tsi of Az, LLC | Clinic/Center | Navajo Reservation, St. Michaels, AZ 86511 | 2009-12-31 |
| 1518297241 | Sequel Tsi of Az, LLC | Clinic/Center | Navajo Route 7, Westside Trinity Presbyterian Church, Chinle, AZ 86503 | 2009-12-31 |
| 1982934618 | Sequel Tsi of Az, LLC | Clinic/Center | Highway 163, Kayenta Mobile Home Park #8, Kayenta, AZ 86033 | 2009-12-31 |
| Street Address |
1109 S. CHIEF AVE. WHITE MOUNTAIN APACHE MOTEL. |
| City | WHITERIVER |
| State | AZ |
| Zip Code | 85941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649816778 | Benjamin Robert Bishop | Pharmacist | 200 W Hospital Road, Whiteriver, AZ 85941 | 2019-11-25 |
| 1750922308 | Christal A Brewer | Specialist/Technologist | 1 N 1st Ave, Whiteriver, AZ 85941 | 2019-10-04 |
| 1154880862 | Ivan Atole IIi | Counselor | 302 W Ponderosa St, Whiteriver, AZ 85941 | 2019-03-13 |
| 1912456732 | Jamie Baha | Counselor | 302 West Ponderosa Street, White River, AZ 85941 | 2016-09-22 |
| 1891243382 | Donna Mauree Stevens | Counselor | 302 W. Ponderosa St., Whiteriver, AZ 85941 | 2016-09-14 |
| 1811445307 | Aura Josefina Ortiz | Counselor | 302 W Ponderosa Street, Whiteriver, AZ 85941 | 2016-09-14 |
| 1891152567 | White Mountain Apache Tribe Fire and Rescue | Ambulance | 612 S. Chief Ave, Whiteriver, AZ 85941 | 2016-01-26 |
| 1528450855 | Carla Francis Turrentine | Social Worker | 249 West Ponderosa Street, Whiteriver, AZ 85941 | 2015-02-24 |
| 1477890390 | Muhammad Kanakri | Pharmacist | 200 West Whiteriver, Usphs Indian Hospital, Whitriver, AZ 85941 | 2013-01-11 |
| 1871870980 | Kathleen Wynn | Registered Nurse | 400 Apache Drive, Whiteriver, AZ 85941 | 2011-11-03 |
| Find all providers in zip 85941 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538290119 | Rainbow Treatment Center White Mountain Apache Tribe | Clinic/Center | 302 West Pondersosa, Whiteriver, AZ 85941-1790 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497372908 | A Path of Resilience - Aprbhs - Rose House - LLC | Clinic/Center | 2258 W Wayland Rd, Phoenix, AZ 85041-3753 | 2020-06-30 |
| 1083237630 | The Heart Program | Clinic/Center | 4041 E Flower St, Phoenix, AZ 85018-6433 | 2020-05-18 |
| 1316569056 | Desert Heart Counseling Corp | Clinic/Center | 1536 E Maryland Ave Ste B300, Phoenix, AZ 85014-1475 | 2020-05-16 |
| 1922638055 | Lotus Health Arizona | Clinic/Center | 2600 E Southern Ave Ste I3, Tempe, AZ 85282-7738 | 2020-01-16 |
| 1689218687 | Devine Momentum Phoenix | Clinic/Center | 15342 W Turney Ave, Goodyear, AZ 85395-6323 | 2019-11-01 |
| 1588212195 | Tamarria Denga | Clinic/Center | 10000 N 31st Ave Ste D411, Phoenix, AZ 85051-1358 | 2019-08-27 |
| 1932768975 | Evolve Counseling & Behavioral Health Services | Clinic/Center | 1206 E Warner Rd # 203, Gilbert, AZ 85296-3132 | 2019-06-12 |
| 1073171153 | Heart Song Wellness LLC | Clinic/Center | 8617 W Union Hills Dr Ste 100, Peoria, AZ 85382-7001 | 2019-06-03 |
| 1659936680 | Sedona Family Counseling | Clinic/Center | 130 Castle Rock Rd Unit 65, Sedona, AZ 86351-8876 | 2019-05-06 |
| 1043778756 | Aye Wellness, Pllc | Clinic/Center | 2406 S 24th St Ste E100, Phoenix, AZ 85034-6801 | 2019-03-12 |
| Find all providers with the same taxonomy | ||||
| City | WHITERIVER |
| Zip Code | 85941 |
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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.