Healthcare Provider Details

I. General information

NPI: 1508760638
Provider Name (Legal Business Name): AZ BE WELL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7923 E KIOWA AVE
MESA AZ
85209-5019
US

IV. Provider business mailing address

7923 E KIOWA AVE
MESA AZ
85209-5019
US

V. Phone/Fax

Practice location:
  • Phone: 602-796-6442
  • Fax:
Mailing address:
  • Phone: 602-796-6442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARIA BLAHUT
Title or Position: OWNER/MENTAL HEALTH THERAPIST
Credential: LAC
Phone: 602-796-6442