Organization Active NPI

Stratum Mental Health of Arizona Inc

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1124486469
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
STRATUM MENTAL HEALTH OF ARIZONA INC
Practice address
3104 E Camelback Rd
#2031
Phoenix, AZ 85016-4502
Phone
(855) 578-7288
Fax
(888) 741-7967
NPI assigned
Feb 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Authorized official

Name
Malcolm Orlando Greyson
Title
Owner
Phone
(855) 578-7288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

3104 E Camelback Rd
#2031
Phoenix, AZ 85016-4502

Mailing address

40335 Winchester Rd # E221
Temecula, CA 92591-5500
Phone (855) 578-7288

National Provider Directory

National Provider Directory

Locations

40335 Winchester Rd
Ste E221
Temecula, CA 92591

40335 Winchester Rd
#E221
Temecula, CA 92591

NPI Registry JSON

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1124486469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40335 WINCHESTER RD # E221",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915500",
            "telephone_number": "855-578-7288",
            "fax_number": "888-741-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 E CAMELBACK RD",
            "address_2": "#2031",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164502",
            "telephone_number": "855-578-7288",
            "fax_number": "888-741-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRATUM MENTAL HEALTH OF ARIZONA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "GREYSON",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_middle_name": "ORLANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-578-7288"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Feb 2, 2016; 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.