Provider Demographics
NPI:1962395442
Name:MESA VERDE COUNSELING INC
Entity type:Organization
Organization Name:MESA VERDE COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ASA
Authorized Official - Middle Name:
Authorized Official - Last Name:RHINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-442-0978
Mailing Address - Street 1:PO BOX 1300
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85615-1300
Mailing Address - Country:US
Mailing Address - Phone:520-442-2812
Mailing Address - Fax:520-378-5187
Practice Address - Street 1:2585 E WILCOX DR STE A
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2822
Practice Address - Country:US
Practice Address - Phone:520-442-2812
Practice Address - Fax:520-378-5187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MESA VERDE COUNSELING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ584215Medicaid
AZ205385Medicaid
AZ132588Medicaid