NPIMap

Organization Active NPI

Divine Changing Hands

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
National Provider Identifier
1124649777
Registry record updated Apr 8, 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
DIVINE CHANGING HANDS
Practice address
1550 E McKellips Rd Ste 101
Mesa, AZ 85203-2753
Phone
(480) 597-4951
Fax
(480) 597-3689
NPI assigned
May 5, 2020
Last updated
Apr 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Sirsandra Scott
Title
Owner
Phone
(702) 773-2872

Specialties & licenses 2

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

Addresses

Primary practice location

1550 E McKellips Rd Ste 101
Mesa, AZ 85203-2753

Mailing address

1550 E McKellips Rd Ste 101
Mesa, AZ 85203-2753
Phone (480) 597-4951

Other identifiers 1

IdentifierTypeStateIssuer
080174MedicaidAZ

National Provider Directory

National Provider Directory

Locations

1550 E McKellips Rd
Ste 101
Mesa, AZ 85203
Phone (480) 597-4951

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1124649777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 E MCKELLIPS RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032753",
            "telephone_number": "480-597-4951",
            "fax_number": "480-597-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 E MCKELLIPS RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032753",
            "telephone_number": "480-597-4951",
            "fax_number": "480-597-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CHANGING HANDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "SIRSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-773-2872"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080174",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.