Pine Creek Mental Health Clinic

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PINE CREEK MENTAL HEALTH CLINIC

Practice address

9635 W Sageline Road
Payson, AZ 85541

Phone

(480) 735-8334

NPI assigned

Jun 16, 2021

Last updated

Jun 16, 2021By 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

Alicia Sexton, NPNPI 1932627395

Title

Owner

Phone

(807) 358-3344

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Alicia Sexton, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Payson, AZ
  • NPI 1932627395
  Authorized official Same address or phone

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1760050546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9635 W SAGELINE ROAD",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "85541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 W SAGELINE ROAD",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "85541",
            "telephone_number": "480-735-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE CREEK MENTAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "SEXTON",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "807-358-3344",
        "authorized_official_credential": "NP"
    },
    "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": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Payson, AZ
• Providers in Payson, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.