| Mind 247 Practice LLC | |
|
2728 N 24th Street 2nd Floor Phoenix AZ 85008-1051 | |
| (844) 646-3247 | |
| (480) 546-4048 |
| Full Name | Mind 247 Practice LLC |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2728 N 24th Street, Phoenix, Arizona |
| Authorized Official Name and Position | Aisha Lynn Depriest (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 8446463247 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind 247 Practice LLC 1465 N Scottsdale Rd Ste 400 Scottsdale AZ 85257-3634 Ph: (844) 084-7992 | Mind 247 Practice LLC 2728 N 24th Street 2nd Floor Phoenix AZ 85008-1051 Ph: (844) 646-3247 |
| NPI Number | 1083330682 |
|---|---|
| Provider Enumeration Date | 10/14/2022 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083330682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
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