Mind 247 Practice LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Phoenix, AZ
NPI 1700516382 · NPPES record last updated Jun 15, 2022
Key facts
- NPI
- 1700516382
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- MIND 247 PRACTICE LLC
- Practice address
- 9675 W Camelback Rd
Phoenix, AZ 85037-3667 - Phone
- (844) 646-3247
- NPI assigned
- Jun 15, 2022
- Organization subpart
- No
Authorized official
- Name
- Adrienne Opalka
- Title
- Chief Operations Officer
- Phone
- (917) 838-5514
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 10
Practitioners 5
-
Lafayette Bishop, NP
-
Susan Jostes, PMHNP
-
Felicia D Thomas, LPC-22408
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210916001566 | AZ | Part B Supplier - Clinic/Group Practice | 6406253541 |
Receives reassigned benefits from 106 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mesa, AZ; Scottsdale, AZ; Phoenix, AZ |
National Provider Directory
- Tax ID family
- Mind 247 Practice LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
9675 W Camelback Rd
Phoenix, AZ 85037-3667
Mailing address
1465 N Scottsdale Rd Ste 400
Scottsdale, AZ 85257-3634
Phone (844) 646-3247
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | www.mind24-7.com |
NPI Registry JSON
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655251200000",
"number": "1700516382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 N SCOTTSDALE RD STE 400",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852573634",
"telephone_number": "844-646-3247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9675 W CAMELBACK RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850373667",
"telephone_number": "844-646-3247"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIND 247 PRACTICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-15",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A",
"authorized_official_last_name": "OPALKA",
"authorized_official_first_name": "ADRIENNE",
"authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
"authorized_official_telephone_number": "917-838-5514"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "www.mind24-7.com",
"affiliation": "N",
"address_1": "9675 W Camelback Rd",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850373667",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.