Obsidian Health and Wellness LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

OBSIDIAN HEALTH AND WELLNESS LLC

Practice address

13321 W Indian School Rd
Litchfield Park, AZ 85340-4339

Phone

(000) 000-0000

NPI assigned

Jul 17, 2018

Organization subpart

No

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

Authorized official

Name

Jennifer Flack, LCSW

Title

Director of Clinical Services

Phone

(720) 331-1168

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538092800000",
    "number": "1740766237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13321 W INDIAN SCHOOL RD STE A107",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404339",
            "telephone_number": "602-550-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13321 W INDIAN SCHOOL RD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404339",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSIDIAN HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-09-28",
        "status": "A",
        "authorized_official_last_name": "FLACK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "720-331-1168",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Nudi, CCC-SLP
• Nufoundation Youth Development Mentors and Life Coach Services
• Nufoundation Youth Services LLC.
• Kristin Angeli Oarde, FNP-C
• Obsidian Health and Wellness LLC
• Norma Ochoa, RBT
• Rebecca A Odede, PMHNP
• Patrick Olivas, COTA/L
• Saraih A Olmos, RBT
• Christopher Erik Olson, D.D.S.

• Adult Mental Health Clinic/Center in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.