MEDICARE: ALEVEA MENTAL HEALTH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363AM0700X	Medical Physician Assistant
2	101YM0800X	Mental Health Counselor
3	202D00000X	Integrative Medicine Physician
4	261QM0850X	Adult Mental Health Clinic/Center
5	104100000X	Social Worker
6	171000000X	Military Health Care Provider
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
8	1041C0700X	Clinical Social Worker
9	2084P0800X	Psychiatry Physician
10	261QP2300X	Primary Care Clinic/Center
11	261QS1000X	Student Health Clinic/Center
12	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619482478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEVEA MENTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	2034 E SOUTHERN AVE STE D
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7511
Country	:	US
Telephone Number	:	480-923-6200
Fax Number	:	602-419-3101

Provider Business Practice Location Address
First Line	:	2034 E SOUTHERN AVE
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7522
Country	:	US
Telephone Number	:	480-923-6200
Fax Number	:	602-419-3101

Authorized Official
Title or Position	:	CEO, PROVIDER
Name	:	CHRISTOPHER MICHAEL BRADSHAW
Credential	:	PAC
Telephone Number	:	602-733-0584

Provider Enumeration Date	:	12/02/2017
Last Update Date	:	02/04/2026

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Directions to “ALEVEA MENTAL HEALTH LLC ” Practice Location

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