Mindflex Behavioral Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MINDFLEX BEHAVIORAL HEALTH LLC

Practice address

10926 W Ivory LN
Avondale, AZ 85392-4025

Phone

(623) 398-9124

NPI assigned

Jan 28, 2022

Organization subpart

No

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

Authorized official

Name

Bolatito Oyeronke Okougbo

Title

Pmhnp

Phone

(623) 398-9124

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1841943040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10926 W IVORY LN",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924025",
            "telephone_number": "623-398-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10926 W IVORY LN",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924025",
            "telephone_number": "623-398-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFLEX BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-28",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "OKOUGBO",
        "authorized_official_first_name": "BOLATITO",
        "authorized_official_middle_name": "OYERONKE",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "623-398-9124"
    },
    "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": []
}

• Curtis D Miller, M.D.
• Jada Miller, ED.S.
• Jennifer Miller, LCSW
• Patrick Todd Theodore Miller
• Ti'Ara Minatee
• Mirame Health LLC
• Juan Luis Miranda, PA
• Tammy Mirkazemi
• Theodore Jon Miron, PSY.S.
• James Mitchell

• Psychiatric/Mental Health Nurse Practitioner in Avondale, AZ
• Providers in Avondale, 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 Mar 7, 2023; 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.