Mind 247 Practice LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Phoenix, AZ
NPI 1083330682 · NPPES record last updated Oct 14, 2022
Key facts
- NPI
- 1083330682
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 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
- Organization subpart
- No
Authorized official
- Name
- Aisha Lynn Depriest
- Title
- Director of Credentialing
- Phone
- (844) 646-3247
Other NPIs on the same Medicare enrollment 7
Practitioners 14
-
Mojisola R Balogun, PMHNP
-
Jennifer Lynn Ruth Beaupre, NURSE PRACTITIONER
-
Toni R Crawford-Jonas, APRN-RNP
-
Melinda Callicoat Croci, LPC, LAMFT
-
Troy D. E. Curtis, LPC
-
Abbas Ghazi, PMHNP-BC
-
Laura Beth Masters, FNP
-
Michael S Moore, APRN
-
Kyle Olson, PA-C
-
Amy Priftakis, APN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
10046 N Metro Pkwy W
Phoenix, AZ 85051
Phone (602) 894-2880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | www.mind24-7.com |
Other providers in Phoenix, AZ
- Tanya Renee Minafee
- Carl Masao Minami
- Viktoriya Rantikovna Minasova
- Robin Lee Mincher
- Mind 24-7 Pharmacy Services, LLC
- Mind 247 Practice LLC
- Mind 247 Practice LLC
- Mind 247 Practice LLC
- Mind 247 Practice LLC
- Mind 247 Practice LLC
All providers in Phoenix, AZ · Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.