Equity Behavioral Health, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EQUITY BEHAVIORAL HEALTH, LLC

Practice address

334 W 10TH PL Ste 104
Mesa, AZ 85201-3499

Phone

(401) 480-5544

NPI assigned

Mar 1, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Marilyn Ann Staires, PMHNP-BCNPI 1962724799

Title

Provider, Owner

Phone

(401) 480-5544

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

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

• Marilyn Ann Staires

  • Psychiatric/Mental Health Nurse Practitioner
  • Waddell, AZ
  • NPI 1962724799
  NPD Authorized official

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1992451744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 W 10TH PL STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013499",
            "telephone_number": "401-480-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 W 10TH PL STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013499",
            "telephone_number": "401-480-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUITY BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "STAIRES",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER, OWNER",
        "authorized_official_telephone_number": "401-480-5544",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962724799",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marilyn.staires@equitybehavioral.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "334 W 10th Pl Ste 104",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852013499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, 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 Mar 3, 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.