NPIMap

Organization Active NPI

Mesa Family Therapy LLC

  • Marriage & Family Therapist
  • Mesa, AZ
National Provider Identifier
1982427993
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MESA FAMILY THERAPY LLC
Practice address
1355 N Greenfield Rd
Mesa, AZ 85205-4073
Phone
(480) 256-2907
NPI assigned
Nov 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Courtney Brown, LMFTNPI 1093286171
Title
Owner/Clinical Supervisor
Phone
(480) 256-2907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1355 N Greenfield Rd
Mesa, AZ 85205-4073

Mailing address

5734 E Butte St
Mesa, AZ 85205-5886
Phone (480) 248-5127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250116003991 AZ Part B Supplier - Clinic/Group Practice 0749718815 Receives reassigned benefits from 4 practitioners
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Locations

1355 N Greenfield Rd
Mesa, AZ 85205
Phone (480) 256-2907

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1982427993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5734 E BUTTE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852055886",
            "telephone_number": "480-248-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N GREENFIELD RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054073",
            "telephone_number": "480-256-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA FAMILY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "OWNER/CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "480-256-2907",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.