Serenity Psychiatric Health Inc.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP4183 Issued in AZ

Legal business name

SERENITY PSYCHIATRIC HEALTH INC.

Practice address

143 N McCormick St Ste 103
Prescott, AZ 86301-2725

Phone

(928) 899-7784

Fax

(623) 218-1396

NPI assigned

Feb 1, 2018

Organization subpart

No

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

Authorized official

Name

Inge Gisela Bundchen, NP

Title

President

Phone

(623) 698-2567

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1801394184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 N MCCORMICK ST STE 103",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012725",
            "telephone_number": "928-899-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 N MCCORMICK ST STE 103",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012725",
            "telephone_number": "928-899-7784",
            "fax_number": "623-218-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PSYCHIATRIC HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "BUNDCHEN",
        "authorized_official_first_name": "INGE",
        "authorized_official_middle_name": "GISELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-698-2567",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1942532734",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Prescott, AZ
• Providers in Prescott, 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 Feb 1, 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.