MEDICARE: THE HEALER PSYCHIATRY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1588528970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALER PSYCHIATRY, PLLC

Provider Business Mailing Address
First Line	:	4539 N 22ND ST STE R
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	480-542-4808
Fax Number	:

Provider Business Practice Location Address
First Line	:	4539 N 22ND ST STE R
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	480-542-4808
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SUNITHA JOSE
Credential	:
Telephone Number	:	480-542-4808

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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