Active NPI
Neurobridge Diagnostic and Behavioral Health LLC
- Clinical Psychologist
- Avondale, AZ
National Provider Identifier
1861306409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- NEUROBRIDGE DIAGNOSTIC AND BEHAVIORAL HEALTH LLC
- Practice address
- 13615 W Catalina Dr
Avondale, AZ 85392-3556 - Phone
- (623) 521-4204
- NPI assigned
- Sep 30, 2026
- Last updated
- Sep 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jesus Antonio Lovett II
- Title
- Managing Member
- Phone
- (623) 521-4204
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | NU | Primary |
Addresses
Primary practice location
13615 W Catalina Dr
Avondale, AZ 85392-3556
Mailing address
13615 W Catalina Dr
Avondale, AZ 85392-3556
Phone (623) 521-4204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790726400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790726400000",
"number": "1861306409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13615 W CATALINA DR",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853923556",
"telephone_number": "623-521-4204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13615 W CATALINA DR",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853923556",
"telephone_number": "623-521-4204"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEUROBRIDGE DIAGNOSTIC AND BEHAVIORAL HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-30",
"last_updated": "2026-09-30",
"certification_date": "2026-09-30",
"status": "A",
"authorized_official_last_name": "LOVETT",
"authorized_official_first_name": "JESUS",
"authorized_official_middle_name": "ANTONIO",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "623-521-4204",
"authorized_official_name_suffix": "II"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.