Sa Psychiatry PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SA PSYCHIATRY PLLC

Practice address

12725 N Porter Camp TRL
Prescott Valley, AZ 86315-4406

Phone

(928) 916-7860

Fax

(928) 436-2078

NPI assigned

Dec 3, 2021

Organization subpart

No

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

Authorized official

Name

Stephen Aiello, PMHNP-BCNPI 1740852532

Title

President/Provider

Phone

(928) 916-7860

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Aiello

  • Psychiatry Physician
  • Prescott, AZ
  • NPI 1740852532

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1982362166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 N PORTER CAMP TRL",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863154406",
            "telephone_number": "928-916-7860",
            "fax_number": "928-436-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 N PORTER CAMP TRL",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863154406",
            "telephone_number": "928-916-7860",
            "fax_number": "928-436-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SA PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "AIELLO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT/PROVIDER",
        "authorized_official_telephone_number": "928-916-7860",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.