Caleb Lichtenberger, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

290462 Issued in AZ

Practice address

16620 N 40TH St Ste E1
Phoenix, AZ 85032-3357

Phone

(602) 464-9576

Fax

(602) 626-8901

NPI assigned

May 9, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: ppm2ndchancetreatmentcenters.caleblichtenberger@154160.advancedmd-direct.com

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1194415695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST STE E1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323357",
            "telephone_number": "602-464-9576",
            "fax_number": "602-626-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST STE E1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323357",
            "telephone_number": "602-464-9576",
            "fax_number": "602-626-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENBERGER",
        "first_name": "CALEB",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "290462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libery Manor Resideny, Inc.
• Kyndra Monique Liburd, MD
• Shannon T. Licano
• Michelle Marie Licavoli
• Regan Lichtenberg
• Tamey Lichtenfels-Manalli, M.S.,CCC-SLP
• Christopher S Lichtenwalter, M.D.
• Megan Licking, MS, CCC-SLP
• Lida Redirect Assist LLC
• Jeremy John Liddiard, D.M.D.

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, 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 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.