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General NPI Number Information
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NPI Number | 1366941361
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Entity Type | Organization
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Legal Business Name | PARAMOUNT BEHAVIORAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 1631 W BURNSIDE TRL
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City | PHOENIX
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State | AZ
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Zip | 85085-8071
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Country | US
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Telephone | 623-225-6220
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Fax | 623-518-2349
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Provider Business Mailing Address
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Address Line | PO BOX 10727
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City | GLENDALE
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State | AZ
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Zip | 85318-0727
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Country | US
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Telephone | 623-225-6220
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Fax | 623-518-2349
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ELISE BALLOU
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Credential | PHYSICIAN ASSISTANT
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Telephone | 623-225-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4900
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 45661
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License Number State | AZ
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