Healthcare Provider Details

I. General information

NPI: 1912626193
Provider Name (Legal Business Name): PEAK MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6232 N 7TH ST STE 101
PHOENIX AZ
85014-1850
US

IV. Provider business mailing address

1801 E CAMELBACK ROAD SUITE 102, #1008
PHOENIX AZ
85016
US

V. Phone/Fax

Practice location:
  • Phone: 623-233-0914
  • Fax: 623-321-6050
Mailing address:
  • Phone: 623-233-0914
  • Fax: 623-321-6050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRENT WHITLEY
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: NP
Phone: 828-773-4681