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General NPI Number Information
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NPI Number | 1205539004
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH MATTERS AZ LLC
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 9700 N 91ST ST STE A115
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5036
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Country | US
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Telephone | 480-808-9561
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Fax | 602-532-7725
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Provider Business Mailing Address
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Address Line | 7000 N 16TH ST STE 120-290
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City | PHOENIX
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State | AZ
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Zip | 85020-5512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACITIONER
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Name | ANZHELA DAVYDOV
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Credential | FNP, PMHNP
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Telephone | 480-808-9561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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