Mesa Primary Care LLC

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

MESA PRIMARY CARE LLC

Practice address

864 W Southern Ave
Mesa, AZ 85210-4900

Phone

(602) 690-6901

NPI assigned

Nov 2, 2026

Last updated

Nov 2, 2026By 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

Tahlil Scott

Title

Manager

Phone

(480) 478-0418

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1793577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793577600000",
    "number": "1699674143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104900",
            "telephone_number": "602-690-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104900",
            "telephone_number": "602-690-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-11-02",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "TAHLIL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-478-0418"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Group Psychotherapy Psychologist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Group Psychotherapy Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.