Healthcare Provider Details

I. General information

NPI: 1275457095
Provider Name (Legal Business Name): NURTUREMIND BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 N SCOTTSDALE RD APT 241
SCOTTSDALE AZ
85251-5201
US

IV. Provider business mailing address

8390 E VIA DE VENTURA STE F-110 #2005
SCOTTSDALE AZ
85258
US

V. Phone/Fax

Practice location:
  • Phone: 773-516-3868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JANICE VICENTE
Title or Position: MANAGING MEMBER
Credential: DNP, PMHNP-C
Phone: 773-516-3868