Act Mental Health Services, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ACT MENTAL HEALTH SERVICES, LLC

Practice address

30 Acoma Blvd S
Lake Havasu City, AZ 86403-5957

Phone

(855) 647-4228

NPI assigned

Aug 20, 2018

Last updated

Aug 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. June Ann Staley, PMHNP-BCNPI 1184091845

Title

President

Phone

(855) 647-4228

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, and the practitioner matching its NPPES authorized official.

• June Staley, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Havasu City, AZ
  • NPI 1184091845
  NPD Authorized official

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1992285852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 PONY DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864068432",
            "telephone_number": "507-380-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ACOMA BLVD S",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035957",
            "telephone_number": "855-647-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACT MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "STALEY",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-647-4228",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Rosalie G Abad
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• Allison Adams, CCC-SLP
• Laura Adams, PHARMD
• Advance Physical Therapy & Rehab LLC
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• Aesthetic Dental Care of Arizona, P.C.

• Psychiatric/Mental Health Nurse Practitioner in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.