OrganizationActive
Immanuel Behavioral Health Counseling Clinic
NPI 1104495084 · Clinic/Center · Peoria, AZ
Provider details
- NPI number
- 1104495084
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- 15856
- Organization subpart
- Yes
- Authorized official
- Brenda Pierce, Chief Operating Officer(623) 738-8549
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11301 N 99th Ave Ste 5120
Peoria, AZ 85345-5485
Phone: (623) 876-6379
Fax: (623) 876-6379
Street-level locationGet directions
Mailing address
11301 N 99th Ave Ste 5120
Peoria, AZ 85345-5485
Registry dates
- Enumerated
- 2021-06-23
- Last updated
- 2023-04-27
- Certified
- 2023-04-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.