Phoenix Family Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PHOENIX FAMILY PSYCHIATRY LLC

Practice address

12725 W Indian School Rd Ste E101
Avondale, AZ 85392-9525

Phone

(623) 352-9681

Fax

(623) 283-5685

NPI assigned

Jun 6, 2025

Last updated

Jun 6, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carmen Lervold, PMHNP-BCNPI 1972238731

Title

Owner/Provider

Phone

(623) 352-9681

Specialties & licenses 1

Addresses

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.

• Carmen Lervold, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
  • NPI 1972238731
  NPD Authorized official

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1477447050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 W INDIAN SCHOOL RD STE E101",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929525",
            "telephone_number": "623-352-9681",
            "fax_number": "623-283-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 W INDIAN SCHOOL RD STE E101",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929525",
            "telephone_number": "623-352-9681",
            "fax_number": "623-283-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX FAMILY PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "LERVOLD",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "623-352-9681",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bronsun Bouyasith Phengdy, PTA
• Dametria Phillips
• Phoenix Children's Hospital, Inc.
• Phoenix Children's Medical Group
• Phoenix Diagnostic Imaging Inc
• Phoenix Residential Behavioral Health LLC
• Physiotherapy Associates, Inc. (Select Physical Therapy)
• Mia Picciano, DPT
• Karen Lee Pichon-Tadlock
• Dorothy Piekut, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Avondale, AZ
• Providers in Avondale, 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 Jun 6, 2025; 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.