Theselah Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

THESELAH WELLNESS LLC

Practice address

16416 W Desert Mirage Dr
Surprise, AZ 85388-5491

Phone

(480) 360-1002

NPI assigned

Jul 31, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kalu Okorie, DNP

Title

DNP

Phone

(480) 360-1002

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1144901315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16416 W DESERT MIRAGE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853885491",
            "telephone_number": "480-360-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16416 W DESERT MIRAGE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853885491",
            "telephone_number": "480-360-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THESELAH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "OKORIE",
        "authorized_official_first_name": "KALU",
        "authorized_official_title_or_position": "DNP",
        "authorized_official_telephone_number": "480-360-1002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "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": []
}

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• Providers in Surprise, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.