Theresa L. Costales (NPI# 1518200674, PAC ID# 8628376324) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1518200674 |
| PAC ID by PECOS | 8628376324 |
| Professional Enrollment ID | I20191021001406 |
| Full Name | Theresa L. Costales |
| Organization Legal Name | LIFEWELL BEHAVIORAL WELLNESS |
| Address |
2715 N 3rd St Phoenix AZ 85004-1106 |
| Phone Number | 6028082800 |
| Gender | F |
| Medical School | GEORGETOWN UNIVERSITY OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 4981641818 |
| Number of Group Practice Members | 26 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2715 N 3rd St, Phoenix, AZ 85004-1106 | 6028082800 | LIFEWELL BEHAVIORAL WELLNESS |
| Organization Legal Name | LIFEWELL BEHAVIORAL WELLNESS |
| Physicians | 31 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diana Havill | Psychiatry | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Janice L Cochran | Psychiatry | Lifewell Behavioral Wellness | 6915 E Main St, Mesa, AZ 85207-8229 |
| Nancy B Mullins | Nurse Practitioner | Lifewell Behavioral Wellness | 262 E University Dr, Mesa, AZ 85201-5932 |
| Roger Mayorga | Nurse Practitioner | Lifewell Behavioral Wellness | 40 E Mitchell Dr, Suite 200, Phoenix, AZ 85012-2330 |
| Audrey C Elliott | Nurse Practitioner | Lifewell Behavioral Wellness | 2311 W Royal Palm Rd, Phoenix, AZ 85021-4916 |
| Bruce R Holzman | Psychiatry | Lifewell Behavioral Wellness | 4451 E Oak St, Phoenix, AZ 85008-2410 |
| Mark Allen Wesbrock | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Carlos Diaz | Psychiatry | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Jillian Eve Young | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Bridgette G Balasko | Psychiatry | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Street Address |
2715 N 3RD ST |
| City | PHOENIX |
| State | AZ |
| Zip | 85004-1106 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diana Havill | Psychiatry | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Mark Allen Wesbrock | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Carlos Diaz | Psychiatry | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Jillian Eve Young | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Bridgette G Balasko | Psychiatry | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Samantha Sholeh Willen | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Tanya L Smith | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Veronica Terez Hurd | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Adam Geno | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Brianne Antoinette Terrell | Nurse Practitioner | Lifewell Behavioral Wellness | 2715 N 3rd St, Phoenix, AZ 85004-1106 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Perry S Hiscok | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Ron H Ayanzen | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Michael D Rosellini | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Susannah K Thurman | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Christopher J Macdonald | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Mihra Taljanovic | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Bruce T Curtis | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Ryan James Coleman | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Christopher A Reynolds | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Adam Kupper | Diagnostic Radiology | Smi Imaging LLC | 2830 N 3rd St, Phoenix, AZ 85004-1042 |
| Find all physicians in zip 85004 | |||
| City | PHOENIX |
| Zip Code | 85004 |
| Specialty | PSYCHIATRY |
| City + Specialty | PHOENIX + PSYCHIATRY |
Please comment or provide details below to improve the information on Theresa L. Costales.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.