Healthcare Provider Details

I. General information

NPI: 1083394795
Provider Name (Legal Business Name): CALMCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10220 N 31ST AVE STE 220
PHOENIX AZ
85051-9581
US

IV. Provider business mailing address

10220 N 31ST AVE STE 220
PHOENIX AZ
85051-9581
US

V. Phone/Fax

Practice location:
  • Phone: 623-552-1534
  • Fax: 602-848-2765
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATIE LUEBKE
Title or Position: PMHNP - BC
Credential: PMHNP - BC
Phone: 623-552-1534