MOHAVE NEUROFEEDBACK CLINIC LLC NPI 1174249015

NPI Information

  • NPI: 1174249015
  • Provider Name: MOHAVE NEUROFEEDBACK CLINIC, LLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • :
  • Address: 2701 E ANDY DEVINE AVE STE 101
    KINGMAN, AZ
    ZIP 86401
  • Phone: (928) 263-1045

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NPI Details

MOHAVE NEUROFEEDBACK CLINIC, LLC is a professional counselor in Kingman, AZ. MOHAVE NEUROFEEDBACK CLINIC, LLC NPI is 1174249015. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

2701 E ANDY DEVINE AVE STE 101
KINGMAN, AZ
ZIP 86401-889
Phone: (928) 263-1045
Fax: (928) 597-5172

The provider's authorized official is Audra Nicole Jalbert .
The authorized official title is Owner, Counselor and has the following contact phone number (928) 263-1045.

The enumeration date for this NPI number is 10/12/2022 and was last updated on 3/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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