Healthcare Provider Details

I. General information

NPI: 1699681718
Provider Name (Legal Business Name): PSYCHIATRIC ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 E GUADALUPE RD
TEMPE AZ
85283-3044
US

IV. Provider business mailing address

1030 E GUADALUPE RD
TEMPE AZ
85283-3044
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-9192
  • Fax:
Mailing address:
  • Phone: 480-256-9192
  • Fax: 480-629-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: BAHOO GHAFOOR
Title or Position: OWNER
Credential: MD
Phone: 480-491-1898