Active NPI
Riseabove Mental Health and Wellness, PLLC
- Psychiatric/Mental Health Nurse Practitioner
- Eagle, ID
National Provider Identifier
1124925284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- RISEABOVE MENTAL HEALTH AND WELLNESS, PLLC
- Practice address
- 500 E Shore Dr Ste 200
Eagle, ID 83616-6960 - Phone
- (208) 486-5894
- NPI assigned
- Oct 22, 2026
- Last updated
- Oct 22, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marcela L Azevedo, PMHNP-BC
- Title
- Managing Member
- Phone
- (208) 486-5894
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
500 E Shore Dr Ste 200
Eagle, ID 83616-6960
Mailing address
500 E Shore Dr Ste 200
Eagle, ID 83616-6960
Phone (208) 486-5894
National Provider Directory
National Provider DirectoryLocations
500 E Shore Dr
Ste 200
Eagle, ID 83616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1792627200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792627200000",
"number": "1124925284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 E SHORE DR STE 200",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166960",
"telephone_number": "208-486-5894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E SHORE DR STE 200",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166960",
"telephone_number": "208-486-5894"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RISEABOVE MENTAL HEALTH AND WELLNESS, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-22",
"last_updated": "2026-10-22",
"certification_date": "2026-10-06",
"status": "A",
"authorized_official_last_name": "AZEVEDO",
"authorized_official_first_name": "MARCELA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "208-486-5894",
"authorized_official_credential": "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": []
}
Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.