PSA BEHAVIORAL HEALTH AGENCY (NPI# 1790267011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790267011 |
| Entity Type | Organization |
| Organization Name | PSA BEHAVIORAL HEALTH AGENCY |
| Practice Address |
1415 N 1st St Phoenix AZ 85004-1604 |
| Mailing Address |
2255 W Northern Ave Ste B100 Phoenix AZ 85021-4936 |
| Practice Telephone | 6025955447 |
| Practice Fax Number | 6025954537 |
| Mailing Telephone | 6029951767 |
| Mailing Fax Number | 6029951863 |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2020-03-29 |
| Authorized Official Name | KIMBERLY QUIROS (COO) |
| Authorized Official Telephone | 6029951767 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251K00000X | Public Health or Welfare | OTC9095 | AZ | Agencies |
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366094930 | Psa Behavioral Health Agency | Community/Behavioral Health | 3271 E. Queen Creek Road, Ste. 105, 110, 111, Gilbert, AZ 85297 | 2019-07-12 |
| 1255891065 | Psa Behavioral Health Agency | Community/Behavioral Health | 3341 E Queen Creek Rd Ste 105, Gilbert, AZ 85297-8510 | 2019-03-20 |
| 1700304110 | Psa Behavioral Health Agency | Community/Behavioral Health | 2580 Highway 95 Ste 116, Bullhead City, AZ 86442-7324 | 2017-09-06 |
| 1316304546 | Psa Behavioral Health Agency | Public Health or Welfare | 1308 N Stockton Hill Rd, Suite D, Kingman, AZ 86401-5139 | 2016-01-19 |
| 1467822734 | Psa Behavioral Health Agency | Public Health or Welfare | 4665 S Ash Ave Ste G-1, Tempe, AZ 85282-6765 | 2015-09-30 |
| 1477982395 | Psa Behavioral Health Agency | Public Health or Welfare | 541 E 10th St, Douglas, AZ 85607-2009 | 2013-11-01 |
| 1215362082 | Psa Behavioral Health Agency | Public Health or Welfare | 1326 W Highway 92, Suite K, Bisbee, AZ 85603-1151 | 2013-09-11 |
| 1265877500 | Psa Behavioral Health Agency | Public Health or Welfare | 820 S California Ave, Suite 104, Parker, AZ 85344-5051 | 2013-04-30 |
| 1184965840 | Psa Behavioral Health Agency | Public Health or Welfare | 220 E 6th St, Tucson, AZ 85705-8424 | 2013-03-06 |
| 1366786006 | Psa Behavioral Health Agency | Public Health or Welfare | 4655 S Lakeshore Dr, Tempe, AZ 85282-8328 | 2012-11-19 |
| Street Address |
1415 N 1ST ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85004-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699945261 | Wendy S Kutz | Social Worker | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2008-03-10 |
| 1669015343 | Brittany Andrews | Counselor | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2019-10-24 |
| 1245872530 | Gabriela Becerra | Counselor | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2019-10-08 |
| 1023472610 | Imhr Epicenter | Community/Behavioral Health | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2016-04-08 |
| 1700160462 | Marlena Gonzales Gabaldon | Counselor | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2011-09-29 |
| 1891008280 | Angela E Hernandez | Social Worker | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2010-07-14 |
| 1124350244 | Martha M Palacio | Social Worker | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2010-02-01 |
| 1114254885 | Alexandra O'hannon | Social Worker | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2009-11-17 |
| 1215264221 | Kimberly S Noll | Social Worker | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2009-11-11 |
| 1548596950 | Julie M Hutchens | Counselor | 1415 N 1st St, Phoenix, AZ 85004-1604 | 2009-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396360749 | Ulivvo Inc. | Nurse Practitioner | 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 | 2020-06-11 |
| 1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
| 1770064107 | Edward Jude Stein | Pharmacist | Two Renaissance Square, 40 N Central Ave, Suite 780, Ihs Clinical Support Center, Phoenix, AZ 85004 | 2018-08-23 |
| 1740775303 | Alexander L. Shaw | Dentist | 201 N Central Ave. #1490, Phoenix, AZ 85004 | 2018-06-26 |
| 1497267868 | Michael Dimoff | Registered Nurse | 1850 N. Central Ave, Ste 1600, Phoenix, AZ 85004 | 2017-10-25 |
| 1093231433 | Ezequiel Bautista | Music Therapist | 2702 N 3rd Street, Suite 1000, Phoenix, AZ 85004 | 2017-08-17 |
| 1841742442 | Stacy Maahs | Nurse Practitioner | 500 N 3rd St Ste 155, Phoenix, AZ 85004 | 2016-10-29 |
| 1538537246 | Jessica Lindsay Karlson | Pharmacist | 2302 N Central Ave Ste 7, Phoenix, AZ 85004 | 2015-09-11 |
| 1689059883 | Yvette's Hope Foundation | Home Health | 40 N. Central Ave. Ste. 1400, Phoenix, AZ 85004 | 2015-07-29 |
| 1881082790 | Patricia Russell | Specialist/Technologist | 60 E. Vernon Ave, Arcadia Therapy Services, Phoenix, AZ 85004 | 2014-12-30 |
| Find all providers in zip 85004 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384030 | Great Xpectations LLC | Community/Behavioral Health | 4014 W Christy Dr, Phoenix, AZ 85029-3958 | 2020-10-19 |
| 1386242295 | Mercy Cares LLC | Community/Behavioral Health | 2644 E Paradise Ln Apt D, Phoenix, AZ 85032-2945 | 2020-10-13 |
| 1124626080 | Beia's Families | Community/Behavioral Health | 3230 E Broadway Rd Ste C-235, Phoenix, AZ 85040-2873 | 2020-10-13 |
| 1518564442 | Infinity Groups Homes LLC | Community/Behavioral Health | 3523 E Everett Dr, Phoenix, AZ 85032-5136 | 2020-10-05 |
| 1013524230 | Civara Behavioral Health LLC | Community/Behavioral Health | 4010 W Cactus Rd, Phoenix, AZ 85029-2905 | 2020-10-01 |
| 1043827561 | Crossroads, Inc | Community/Behavioral Health | 2002 E Osborn Rd, Phoenix, AZ 85016-7236 | 2020-09-29 |
| 1043827025 | Guiding Steps Health Services, LLC | Community/Behavioral Health | 4926 E Mcdowell Rd, Phoenix, AZ 85008-4294 | 2020-09-24 |
| 1154931566 | Apex Transitional Housing Inc | Community/Behavioral Health | 13827 N 11th St, Phoenix, AZ 85022-4316 | 2020-08-01 |
| 1356959126 | Rock House Az, LLC | Community/Behavioral Health | 8650 N 35th Ave Ste 110, Phoenix, AZ 85051-3835 | 2020-07-17 |
| 1215554902 | Lydia Barton | Community/Behavioral Health | 1420 W Missouri Ave, Phoenix, AZ 85013-1919 | 2020-06-29 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.