Healthcare Provider Details
I. General information
NPI: 1972229375
Provider Name (Legal Business Name): ADVANCED PSYCHIATRIC HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2022
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4435 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7651
US
IV. Provider business mailing address
4435 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7651
US
V. Phone/Fax
- Phone: 480-930-2322
- Fax: 480-546-4964
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMARA
MEGWA
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: PMHNP
Phone: 480-930-2322