NPIMap

Organization Active NPI

Mind 247 Practice LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1083330682
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIND 247 PRACTICE LLC
Practice address
2728 N 24TH Street
2ND Floor
Phoenix, AZ 85008-1051
Phone
(844) 646-3247
Fax
(480) 546-4048
NPI assigned
Oct 14, 2022
Last updated
Oct 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Authorized official

Name
Aisha Lynn Depriest
Title
Director of Credentialing
Phone
(844) 646-3247

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2728 N 24TH Street
2ND Floor
Phoenix, AZ 85008-1051

Mailing address

1465 N Scottsdale Rd Ste 400
Scottsdale, AZ 85257-3634
Phone (844) 084-7992

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL www.mind24-7.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210916001566 AZ Part B Supplier - Clinic/Group Practice 6406253541 Receives reassigned benefits from 106 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mesa, AZ; Scottsdale, AZ; Phoenix, AZ

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1083330682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 N SCOTTSDALE RD STE 400",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573634",
            "telephone_number": "844-084-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 N 24TH STREET",
            "address_2": "2ND FLOOR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850081051",
            "telephone_number": "844-646-3247",
            "fax_number": "480-546-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND 247 PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "DEPRIEST",
        "authorized_official_first_name": "AISHA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "844-646-3247"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "www.mind24-7.com",
            "affiliation": "N",
            "address_1": "2728 N 24th Street",
            "address_2": "2nd Floor",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850081051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.