NPIMap

Organization Active NPI

Matrix Mental Health LLC

Doing business as Matrix Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Oro Valley, AZ
National Provider Identifier
1427779461
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MATRIX MENTAL HEALTH LLC
Doing business as
Matrix Mental Health
Practice address
1846 E Innovation Park Dr Ste 100
Oro Valley, AZ 85755-1963
Phone
(602) 830-8400
Fax
(602) 834-2100
NPI assigned
Sep 8, 2022
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Vincent Ekstrom, DNP, PMHNP-BCNPI 1124644794
Title
Psychiatric Nurse Practitioner
Phone
(602) 489-9606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1846 E Innovation Park Dr Ste 100
Oro Valley, AZ 85755-1963

Mailing address

1846 E Innovation Park Dr Ste 100
Oro Valley, AZ 85755-1963
Phone (602) 830-8400

Other names 1

  • Matrix Mental Health Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1427779461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1846 E INNOVATION PARK DR STE 100",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857551963",
            "telephone_number": "602-830-8400",
            "fax_number": "602-834-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1846 E INNOVATION PARK DR STE 100",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857551963",
            "telephone_number": "602-830-8400",
            "fax_number": "602-834-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "EKSTROM",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "602-489-9606",
        "authorized_official_credential": "DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrix Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Matrix Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oro Valley, AZ

Sources for this page

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