NPIMap

Organization Active NPI

Octave Behavioral Michigan PC

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1801640081
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
OCTAVE BEHAVIORAL MICHIGAN PC
Practice address
8825 N 23Rd Ave Ste 100
Phoenix, AZ 85021-4148
Phone
(415) 360-3833
Fax
(628) 234-3048
NPI assigned
Apr 15, 2024
Last updated
Jun 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Kym Everett
Title
VP, Revenue Operations
Phone
(650) 504-2289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

8825 N 23Rd Ave Ste 100
Phoenix, AZ 85021-4148

Mailing address

625 Market St FL 15
San Francisco, CA 94105-3316
Phone (415) 360-3833

Other practice location 1

4539 N 22nd St Ste 200
Phoenix, AZ 85016-4661
Phone (415) 360-3833

Other practice location 2

18001 N 79th Ave
Glendale, AZ 85308-8388
Phone (415) 360-3833

Other practice location 3

20485 N Candlelight Rd
Maricopa, AZ 85138-0032
Phone (415) 360-3833

National Provider Directory

National Provider Directory
Tax ID family
Octave Behavioral Michigan PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18001 N 79th Ave
Glendale, AZ 85308
Phone (480) 219-3600

4539 N 22nd St
Ste 200
Phoenix, AZ 85016
Phone (323) 509-4325

NPI Registry JSON

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1801640081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MARKET ST FL 15",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941053316",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 N 23RD AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214148",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4539 N 22nd St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164661",
            "country_code": "US",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18001 N 79th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853088388",
            "country_code": "US",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20485 N Candlelight Rd",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "851380032",
            "country_code": "US",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OCTAVE BEHAVIORAL MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "KYM",
        "authorized_official_title_or_position": "VP, REVENUE OPERATIONS",
        "authorized_official_telephone_number": "650-504-2289"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.