Healthcare Provider Details

I. General information

NPI: 1518836204
Provider Name (Legal Business Name): HOLISTIC PSYCHIATRY AND WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6430 N SWAN RD STE 110
TUCSON AZ
85718-3641
US

IV. Provider business mailing address

6430 N SWAN RD STE 110
TUCSON AZ
85718-3641
US

V. Phone/Fax

Practice location:
  • Phone: 520-200-7959
  • Fax:
Mailing address:
  • Phone: 520-200-7959
  • 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. SUSSAN LEE GOLDSWORTHY
Title or Position: CEO
Credential: DNP, PMHNP-BC
Phone: 520-200-7959