MIKID, MENTALLY ILL KIDS IN DISTRESS (NPI# 1891701280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891701280 |
| Entity Type | Organization |
| Organization Name | MIKID, MENTALLY ILL KIDS IN DISTRESS |
| Practice Address |
755 E Willetta St Ste. 128 Phoenix AZ 85006-2723 |
| Practice Telephone | 6022531240 |
| Practice Fax Number | 6022531250 |
| Mailing Telephone | 6022531240 |
| Mailing Fax Number | 6022531250 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. VICKI LYNN JOHNSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6022531240 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | CSA05CP0172 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 895394 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801026539 | Mikid, Mentally Ill Kids In Distress | Community/Behavioral Health | 100 E 24th St, Yuma, AZ 85364-8619 | 2009-07-15 |
| 1922036599 | Mikid, Mentally Ill Kids In Distress | Voluntary or Charitable | 755 E Willetta St, Ste 128, Phoenix, AZ 85006-2723 | 2006-06-30 |
| 1902116312 | Mikid, Mentally Ill Kids In Distress | Respite Care | 2957 N Us Highway 89, Prescott, AZ 86301-4963 | 2010-10-19 |
| 1144554197 | Mikid, Mentally Ill Kids In Distress | Community/Behavioral Health | 367 N Main St, Suite 4, Eagar, AZ 85925-9675 | 2009-09-23 |
| Street Address |
755 E WILLETTA ST STE. 128 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85006-2723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922036599 | Mikid, Mentally Ill Kids In Distress | Voluntary or Charitable | 755 E Willetta St, Ste 128, Phoenix, AZ 85006-2723 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949929 | Teresa Louise Cox | Pharmacist | 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 | 2020-10-15 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1023638582 | Supraja Prakash | Genetic Counselor, MS | 1920 E Cambridge Ave., Rosenberg Bldg., Suite 304, Phoenix, AZ 85006 | 2020-04-24 |
| 1760017099 | Phoenix Medical Psychiatric Hospital, LLC | Psychiatric Hospital | 1346 Mcdowell Road, Phoenix, AZ 85006 | 2020-03-06 |
| 1265093108 | Zulianna Ibrahim | Student in an Organized Health Care Education/Training Program | Banner University Medical Center Phoenix Family Medicin, 1300 N. 12th Street Suite 605, Phoenix, AZ 85006 | 2019-06-21 |
| 1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
| 1477032357 | Joann Moskop | Chiropractor | 2719 N Greenfield Rd., Phoenix, AZ 85006 | 2018-08-10 |
| 1619464468 | Ana Maria Lara | Naturopath | 926 E Mcdowell Rd Ste 204, Phoenix, AZ 85006 | 2018-04-17 |
| 1194221770 | Nisha Bharat Patel | Student in an Organized Health Care Education/Training Program | Edwards Medical Plaza Suite 320, 1300 North 12th Street, Phoenix, AZ 85006 | 2018-04-03 |
| 1710486352 | Julia Cyr | Registered Nurse | 1008 E Mcdowell Rd Unit A, Phoenix, AZ 85006 | 2018-02-09 |
| Find all providers in zip 85006 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518457290 | Raising Special Kids | Voluntary or Charitable | 5025 E Washington St Ste 204, Phoenix, AZ 85034-7439 | 2018-05-17 |
| 1174885271 | Music Therapy Matters | Voluntary or Charitable | 625 W Deer Valley Rd Ste 103310, Phoenix, AZ 85027-2185 | 2012-06-13 |
| 1467710723 | Seeds for Autism | Voluntary or Charitable | 711 N 15th Ave, Phoenix, AZ 85007-2251 | 2012-04-24 |
| 1851623169 | Ronald Mcdonald House Charities of Phoenix | Voluntary or Charitable | 501 E Roanoke Ave, Phoenix, AZ 85004-1013 | 2010-02-11 |
| 1255538732 | Family Service Agency | Voluntary or Charitable | 10220 N 31st Ave Ste 103-105, Phoenix, AZ 85051-9581 | 2007-06-28 |
| 1255547444 | Lifewell Behavioral Wellness | Voluntary or Charitable | 119 W. Highland Avenue, Phoenix, AZ 85013-4707 | 2007-05-15 |
| 1639290471 | Area Agency On Aging, Region One, Inc | Voluntary or Charitable | 1366 E Thomas Rd, Suite 108, Phoenix, AL 85014 | 2007-04-02 |
| 1366574279 | Life Choices Womens Clinic | Voluntary or Charitable | 9303 N 7th Street, Suite 4, Phoenix, AZ 85020 | 2007-03-09 |
| 1154471175 | New Arizona Family, Inc | Voluntary or Charitable | 2019 N 25th Pl, Phoenix, AZ 85008-2774 | 2007-01-11 |
| 1871664680 | Friendly House, Inc. | Voluntary or Charitable | 802 S 1st Ave, Phoenix, AZ 85003-2504 | 2006-11-13 |
| 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.