Koroma Family Wellness LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KOROMA FAMILY WELLNESS LLC

Practice address

1457 W Southern Ave Ste A3
Mesa, AZ 85202-4813

Phone

(602) 838-9434

NPI assigned

Jan 31, 2023

Organization subpart

No

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

Authorized official

Name

Audrey Pope

Title

Owner

Phone

(214) 577-4850

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1245936301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1457 W SOUTHERN AVE STE A3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024813",
            "telephone_number": "602-838-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 W SOUTHERN AVE STE A3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024813",
            "telephone_number": "602-838-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOROMA FAMILY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-577-4850"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah S Korbitz, CNP
• Melissa Korey
• Britany R Kormos, NP-C
• Jeffrey Scott Korn, D.C.
• Michael Kornreich, M.D.
• Emily Marie Kosenske
• Jennifer Marie Kosisky, DNP, WHNP-BC
• Jan Frances Koslowski, PTA
• Malgorzata Kostrzewa, NP
• Radha Krishna Kothapalli, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.