Healthcare Provider Details

I. General information

NPI: 1821820663
Provider Name (Legal Business Name): AZ MINDCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3295 N DRINKWATER BLVD STE 10
SCOTTSDALE AZ
85251-6437
US

IV. Provider business mailing address

3295 N DRINKWATER BLVD STE 10
SCOTTSDALE AZ
85251-6437
US

V. Phone/Fax

Practice location:
  • Phone: 480-861-9202
  • Fax: 480-535-1638
Mailing address:
  • Phone: 480-861-9202
  • Fax: 480-535-1638

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: MICHELLE LIANE MORGAN
Title or Position: OWNER/PROVIDER
Credential: PMHNP-BC
Phone: 480-861-9202