Organization Active NPI

Summit Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1497370258
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SUMMIT BEHAVIORAL HEALTH PLLC
Practice address
8230 E Broadway Blvd Ste E7
Tucson, AZ 85710-4002
Phone
(520) 468-9844
NPI assigned
Jun 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Misty McGillem, DNP
Title
Managing Member
Phone
(520) 468-9844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

8230 E Broadway Blvd Ste E7
Tucson, AZ 85710-4002

Mailing address

8110 S Houghton Rd
Ste 158 PMB 136
Tucson, AZ 85747
Phone (520) 468-9844

Other names 1

  • Summit Behavioral Health, PLLC Former legal business name

National Provider Directory

National Provider Directory

Locations

8230 E Broadway Blvd
Ste E7
Tucson, AZ 85710
Phone (520) 468-9844

6524 E Carondelet Dr
Tucson, AZ 85710
Phone (520) 344-7830

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1497370258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 S HOUGHTON RD",
            "address_2": "STE 158 PMB 136",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85747",
            "telephone_number": "520-468-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 E BROADWAY BLVD STE E7",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857104002",
            "telephone_number": "520-468-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "MCGILLEM",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "520-468-9844",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Behavioral Health, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Summit Behavioral Health, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.