Organization Active NPI

Grace Mental Health Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sedona, AZ
National Provider Identifier
1790458479
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GRACE MENTAL HEALTH SERVICES PLLC
Practice address
2350 W Highway 89a # 1023
Sedona, AZ 86336-5344
Phone
(800) 789-3543
Fax
(928) 496-2133
NPI assigned
Jul 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Authorized official

Name
Mary M Ndumbe, PHMNP
Title
Sole Owner/Admin
Phone
(800) 789-3543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2350 W Highway 89a # 1023
Sedona, AZ 86336-5344

Mailing address

15784 W Desert Mirage Dr
Surprise, AZ 85379-4639
Phone (800) 789-3543

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1790458479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15784 W DESERT MIRAGE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853794639",
            "telephone_number": "800-789-3543",
            "fax_number": "928-496-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 W HIGHWAY 89A # 1023",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365344",
            "telephone_number": "800-789-3543",
            "fax_number": "928-496-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MENTAL HEALTH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "NDUMBE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE OWNER/ADMIN",
        "authorized_official_telephone_number": "800-789-3543",
        "authorized_official_credential": "PHMNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedona, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.