Empact - Suicide Prevention Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH-4162 Issued in AZ

Legal business name

EMPACT - SUICIDE PREVENTION CENTER

Practice address

21476 N John Wayne Pkwy Ste C101
Maricopa, AZ 85139-8984

Phone

(520) 316-6068

Fax

(520) 568-6289

NPI assigned

Jun 26, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Erica Chestnut-Ramirez, MC, LIAC

Title

Regional Vice President

Phone

(480) 784-1514

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EMPACT-SPC Other name

Locations

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1477715803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S. MADISON DRIVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852817248",
            "telephone_number": "480-784-1514",
            "fax_number": "480-967-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21476 N JOHN WAYNE PKWY STE C101",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398984",
            "telephone_number": "520-316-6068",
            "fax_number": "520-568-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPACT - SUICIDE PREVENTION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "CHESTNUT-RAMIREZ",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "REGIONAL VICE PRESIDENT",
        "authorized_official_telephone_number": "480-784-1514",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MC, LIAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "3046",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-4162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPARTMENT OF HEALTH SERVICES BEHAVIORAL HEALTH LICENSE",
            "identifier": "3046",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMPACT-SPC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "EMPACT-SPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Darrell Lemont Ellis Jr., ADMINISTRATOR
• Shannon Ellis
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• Empact - Suicide Prevention Center (La Frontera EMPACT-SPC)
• Empact - Suicide Prevention Center (Empact-SPC)
• Empower Mental Health Solutions LLC (Clearwater Counseling)
• Enchanted Sky Family Psychiatry, PLLC
• Rebecca Engel
• Ep Loving Hands in-Home Care LLC

• Community/Behavioral Health Agency in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.