NPIMap

Organization Active NPI

Mentally Ill Kids in Distress

  • Community/Behavioral Health Agency
  • Kingman, AZ
National Provider Identifier
1851735369
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC7588 Issued in AZ
Legal business name
MENTALLY ILL KIDS IN DISTRESS
Practice address
2615 E Beverly Ave
Kingman, AZ 86409-3631
Phone
(602) 253-1240
Fax
(602) 253-1250
NPI assigned
Apr 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Authorized official

Name
Matt Auna, BHT
Title
Ceo
Phone
(480) 414-4879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC7588 AZ Primary

Addresses

Primary practice location

2615 E Beverly Ave
Kingman, AZ 86409-3631

Mailing address

7816 N 19TH Ave
Phoenix, AZ 85021-7036
Phone (602) 253-1240

Other names 1

  • MIKID Other name

National Provider Directory

National Provider Directory
Tax ID family
Mentally Ill Kids in Distress12 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.

NPI Registry JSON

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1851735369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7816 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217036",
            "telephone_number": "602-253-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E BEVERLY AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093631",
            "telephone_number": "602-253-1240",
            "fax_number": "602-253-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTALLY ILL KIDS IN DISTRESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-26",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "AUNA",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-414-4879",
        "authorized_official_credential": "BHT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC7588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIKID",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MIKID",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.