Organization Active NPI

Psychiatric Solutions LLC

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1649001736
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRIC SOLUTIONS LLC
Practice address
10000 N 31St Ave Ste C100-138
Phoenix, AZ 85051-1395
Phone
(623) 308-2472
NPI assigned
Aug 9, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Kristine Abigael Malcomson, FNP-C, PMHNP-BCNPI 1609457027
Title
Owner
Phone
(602) 568-9556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

10000 N 31St Ave Ste C100-138
Phoenix, AZ 85051-1395

Mailing address

19801 N 59TH Ave Unit 10116
Glendale, AZ 85318-5006
Phone (623) 308-2472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240927000993 AZ Part B Supplier - Clinic/Group Practice 4486185733 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, AZ

National Provider Directory

National Provider Directory

Locations

19801 N 59th Ave
Unit 10116
Glendale, AZ 85318

15262 N 75th Ave
Ste 102
Peoria, AZ 85381
Phone (602) 878-8868

10000 N 31st Ave
Ste C100
Phoenix, AZ 85051
Phone (602) 466-3686

Practitioners & affiliated clinicians

Practitioners 2

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": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1649001736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19801 N 59TH AVE UNIT 10116",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853185006",
            "telephone_number": "623-308-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 N 31ST AVE STE C100-138",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511395",
            "telephone_number": "623-308-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "MALCOMSON",
        "authorized_official_first_name": "KRISTINE ABIGAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-568-9556",
        "authorized_official_credential": "FNP-C, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.