Northsight Recovery LLC

Primary specialty

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

Legal business name

NORTHSIGHT RECOVERY LLC

Practice address

1440 E Southern Ave
Tempe, AZ 85282-5612

Phone

(480) 544-0283

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Jeremy Bloom

Title

Member/Ceo

Phone

(480) 544-0283

Specialties & licenses 8

Addresses

Other identifiers 4

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Northsight Recovery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northsight Recovery LLC

  dba Northsight Recovery- Mesa

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1558132704
  NPD tax ID

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danielle N Hansen, PMHNP-BC, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Tempe, AZ
  • NPI 1407512601
  NPD
• Courtney Smith

  • Case Manager/Care Coordinator
  • Perris, CA
  • NPI 1083222822
  NPD
• Judith M Browne, PSY.D.

  • Clinical Psychologist
  • Phoenix, AZ
  • NPI 1902217193
  NPD (past)
• Shawn Patrick Gallo, LISAC, CADAC

  • Addiction (Substance Use Disorder) Counselor
  • Tempe, AZ
  • NPI 1588397434
  NPD (past)
• Danyashae Martinez, PMHP-BC, FNP-C

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1205470598
  NPD (past)
• Brittany Pierce, PSYD

  • Psychologist
  • Tempe, AZ
  • NPI 1861840001
  NPD (past)

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1477212306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10441 E THATCHER AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128338",
            "telephone_number": "480-544-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825612",
            "telephone_number": "480-544-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIGHT RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MEMBER/CEO",
        "authorized_official_telephone_number": "480-544-0283"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "03D2245576",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOINT COMISSION",
            "identifier": "687990",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY STATE LICENSE",
            "identifier": "OTC11514",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109815",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Tempe, AZ
• Providers in Tempe, 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 Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.