Fidel Psychiatric Health Services

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

FIDEL PSYCHIATRIC HEALTH SERVICES

Practice address

924 W Jessica LN
Phoenix, AZ 85041-3978

Phone

(480) 332-8764

Fax

(602) 323-1769

NPI assigned

Feb 16, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Fidelis Osondu Ebereonwu, MSN PMHNP-BC

Title

Director

Phone

(480) 332-8764

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1033702519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 W JESSICA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850413978",
            "telephone_number": "480-332-8764",
            "fax_number": "602-323-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 W JESSICA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850413978",
            "telephone_number": "480-332-8764",
            "fax_number": "602-323-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDEL PSYCHIATRIC HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "EBEREONWU",
        "authorized_official_first_name": "FIDELIS",
        "authorized_official_middle_name": "OSONDU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-332-8764",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSN PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.