Provider Demographics
NPI: | 1235311499 |
---|---|
Name: | CAREFREE PSYCHOLOGICAL SERVICES, PLLC |
Entity type: | Organization |
Organization Name: | CAREFREE PSYCHOLOGICAL SERVICES, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING MEMBER/ PSYCHOLOGIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | RONALD |
Authorized Official - Middle Name: | RAYMOND |
Authorized Official - Last Name: | SUMMERHILL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PSYD |
Authorized Official - Phone: | 480-488-7876 |
Mailing Address - Street 1: | PO BOX 2987 |
Mailing Address - Street 2: | |
Mailing Address - City: | CAREFREE |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85377-2987 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 480-488-7876 |
Mailing Address - Fax: | 480-488-7432 |
Practice Address - Street 1: | 7171 E CAVE CREEK RD |
Practice Address - Street 2: | SUITE P |
Practice Address - City: | CAREFREE |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85377-2987 |
Practice Address - Country: | US |
Practice Address - Phone: | 480-488-7876 |
Practice Address - Fax: | 480-488-7432 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-11-29 |
Last Update Date: | 2007-11-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NE | 1111 | 101YP2500X |
AZ | 3809 | 103G00000X, 103TB0200X, 103TC0700X, 103TC2200X |
AZ | 2029 | 103TA0400X, 103TA0700X, 103TF0000X, 103TF0200X, 103TH0004X, 103TP2701X, 106H00000X |
AZ | 2026 | 103TC0700X |
AZ | 103TS0200X | |
IA | 08246 | 104100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103G00000X | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | Group - Multi-Specialty | |
No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging | Group - Multi-Specialty |
No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | Group - Multi-Specialty |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
No | 103TF0200X | Behavioral Health & Social Service Providers | Psychologist | Forensic | Group - Multi-Specialty |
No | 103TH0004X | Behavioral Health & Social Service Providers | Psychologist | Health | Group - Multi-Specialty |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
No | 103TS0200X | Behavioral Health & Social Service Providers | Psychologist | School | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |