MEDICARE: GROVE COMPREHENSIVE PSYCHIATRY AND WELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1144196171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROVE COMPREHENSIVE PSYCHIATRY AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	6402 E SUPERSTITION SPRINGS BLVD STE 224
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4394
Country	:	US
Telephone Number	:	480-470-3442
Fax Number	:

Provider Business Practice Location Address
First Line	:	6402 E SUPERSTITION SPRINGS BLVD STE 224
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4394
Country	:	US
Telephone Number	:	480-470-3442
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	BRIGHAM JOHN NICOLL
Credential	:	MD
Telephone Number	:	480-272-1099

Provider Enumeration Date	:	10/16/2025
Last Update Date	:	12/16/2025

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