Healthcare Provider Details

I. General information

NPI: 1205302270
Provider Name (Legal Business Name): PSYCH ZENHEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2018
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 E INDIAN SCHOOL RD STE 700
PHOENIX AZ
85014-4846
US

IV. Provider business mailing address

1095 E INDIAN SCHOOL RD STE 700
PHOENIX AZ
85014-4846
US

V. Phone/Fax

Practice location:
  • Phone: 623-225-7591
  • Fax: 623-230-3726
Mailing address:
  • Phone: 623-225-7591
  • Fax: 623-230-3726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JOSIAH NNADOZIE NWAOKWA
Title or Position: NURSE PRACTITIONER
Credential: PMHNP
Phone: 623-225-7591