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ADAM BONVENTRE
NPI 1154065829
Counselor - Mental Health in Glendale, AZ

Active since April 27, 2022Opted out of Medicare · through Jan 1, 2028
17235 N 75TH AVE STE F100, GLENDALE, AZ 85308(480) 641-1165 Get Directions Write a Review

NPPES record last updated: April 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Adam Bonventre NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADAM BONVENTRE (NPI 1154065829) is an individual mental health provider in Glendale, Arizona and active in the NPI registry since April 2022. He has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1154065829
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameADAM BONVENTRE
Location Address17235 N 75TH AVE STE F100Glendale, AZ 85308-0871
Mailing Address17235 N 75th Ave Ste F100Glendale, AZ 85308-0871
Phone(480) 641-1165
Sole ProprietorNo
Enumeration DateApril 27, 2022
NPPES CertifiedApril 27, 2022
✔ NPI 1154065829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
17235 N 75TH AVE STE F100, Glendale, AZ 85308
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Adam Bonventre has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE MARIE HANLON
Counselor (Addiction (Substance Use Disorder))
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (480) 641-1165
PARVEEN BOBBY SHAIK
Counselor (Mental Health)
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (480) 641-1165
PAMELA (PAM) ANN EDWARDS
Student in an Organized Health Care Education/Training Program
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (480) 641-1165
YADIRA BRITO
Counselor
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (602) 446-6013
ALEXANDRIA DESEREE FLORES
Counselor (Mental Health)
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (623) 760-2656
ELIANA BENDER
Counselor
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (480) 641-1165
KACIE MAROLDA
Counselor (Professional)
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (520) 507-7632
MRS. QUINYATTA SHALEISH WASHINGTON
Counselor (Mental Health)
17235 N 75TH AVE STE F100
GLENDALE, AZ 85308
Maricopa County (480) 641-1165

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adam Bonventre's NPI number?

The NPI number for Adam Bonventre is 1154065829. It was assigned to this individual provider in the NPPES registry on April 27, 2022.

Where is Adam Bonventre located?

Adam Bonventre practices at 17235 N 75th Ave Ste F100, Glendale, AZ 85308. The listed phone number is (480) 641-1165.

What is Adam Bonventre's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Adam Bonventre enrolled in Medicare?

No. Adam Bonventre has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Adam Bonventre was last updated on April 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.