Individual provider Active NPI

Jonathon Shasteen, PHD, NCSP, LP

  • Psychologist
  • Mesa, AZ
National Provider Identifier
1922809300
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
005982 Issued in AZ
Practice address
1745 S Alma School Rd Ste 145
Mesa, AZ 85210-3049
Phone
(602) 704-2345
NPI assigned
Mar 21, 2025
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 005982 AZ Primary

Addresses

Primary practice location

1745 S Alma School Rd Ste 145
Mesa, AZ 85210-3049

Mailing address

1745 S Alma School Rd Ste 145
Mesa, AZ 85210-3049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250604004015 AZ Practitioner - Clinical Psychologist 8921517467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Center of America, LLCGroup PAC ID 7012308257, 9 clinicians

Practice addresses (Care Compare)

7600 N 15TH St
Suite 100
Phoenix, AZ 85020-4330
Phone (602) 704-2345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
005982AZMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of America, LLC CurrentSince Mar 24, 2025 Accepting new patients

Locations

1 N 1st St
Fl 7
Phoenix, AZ 85004

7600 N 15th St
Ste 100
Phoenix, AZ 85020
Phone (602) 224-2277

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1922809300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 S ALMA SCHOOL RD STE 145",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 S ALMA SCHOOL RD STE 145",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103049",
            "telephone_number": "602-704-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASTEEN",
        "first_name": "JONATHON",
        "credential": "PHD, NCSP, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "005982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.