Healthcare Provider Details

I. General information

NPI: 1740147545
Provider Name (Legal Business Name): BRIGHTMIND BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST STE R
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

4539 N 22ND ST STE R
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 657-390-1400
  • Fax: 800-930-7957
Mailing address:
  • Phone: 657-390-1400
  • Fax: 800-930-7957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ANA MUNOZ
Title or Position: ASST DIRECTOR OF PATIENT RELATIONS
Credential: MA
Phone: 310-367-9845