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NPI 1861379794

NPI 1861379794 : IMPACT MINDS LLC : SCOTTSDALE, AZ

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General NPI Number Information
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    NPI Number           |    1861379794
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    Entity Type          |    Organization 
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    Legal Business Name  |    IMPACT MINDS LLC 
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Dates
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    Enumeration Date     |    08/20/2025
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    Last Update Date     |    08/20/2025
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Provider Practice Location Address
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    Address Line         |    15170 N HAYDEN RD STE 1 
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85260-2571
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    Country              |    US
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    Telephone            |    561-699-0706
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4400 N SCOTTSDALE RD # 9-918 
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85251-3331
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    Country              |    US
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    Telephone            |    480-332-8832
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     STEVEN  SCHAPIRO 
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    Credential           |    
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    Telephone            |    561-699-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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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        |    207QA0401X
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    Taxonomy Name        |    Addiction Medicine (Family Medicine) Physician
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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        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    261QM1300X
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    Taxonomy Name        |    Multi-Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #5
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    Taxonomy Code        |    261QM2500X
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    Taxonomy Name        |    Medical Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #6
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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