Organization Active NPI

Majestic Wellness Clinics, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1265122279
Registry record updated Mar 12, 2025
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
MAJESTIC WELLNESS CLINICS, INC
Practice address
2720 E Thomas Rd Ste 170B
Phoenix, AZ 85016-8230
Phone
(800) 689-6958
NPI assigned
May 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Authorized official

Name
Shafique Kakooza
Title
Ceo
Phone
(800) 689-6958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2720 E Thomas Rd Ste 170B
Phoenix, AZ 85016-8230

Mailing address

2720 E Thomas Rd Ste 170B
Phoenix, AZ 85016-8230
Phone (800) 689-6958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231110002353 AZ Part B Supplier - Clinic/Group Practice 4688021777 Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

2150 W Camelback Rd
Phoenix, AZ 85015
Phone (415) 424-0419

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1265122279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 E THOMAS RD STE 170B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168230",
            "telephone_number": "800-689-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 E THOMAS RD STE 170B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168230",
            "telephone_number": "800-689-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC WELLNESS CLINICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "KAKOOZA",
        "authorized_official_first_name": "SHAFIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-689-6958"
    },
    "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": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.