Organization Active NPI

Mira Psychiatry Group PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tempe, AZ
National Provider Identifier
1790607208
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIRA PSYCHIATRY GROUP PLLC
Practice address
405 W Southern Ave Ste 105
Tempe, AZ 85282-4500
Phone
(480) 900-0965
NPI assigned
Jul 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Authorized official

Name
Thomas Mathew, FNP-C, PMHNP-CNPI 1770297566
Title
Owner
Phone
(480) 900-0965

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

405 W Southern Ave Ste 105
Tempe, AZ 85282-4500

Mailing address

22424 S Ellsworth Loop Rd Unit 784
Queen Creek, AZ 85142-7107

National Provider Directory

National Provider Directory

Locations

22424 S Ellsworth Loop Rd
Unit 784
Queen Creek, AZ 85142
Phone (480) 900-0965

405 W Southern Ave
Ste 105
Tempe, AZ 85282

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1785110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1790607208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22424 S ELLSWORTH LOOP RD UNIT 784",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W SOUTHERN AVE STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852824500",
            "telephone_number": "480-900-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA PSYCHIATRY GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-900-0965",
        "authorized_official_credential": "FNP-C, PMHNP-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.