PHOENIX MENTAL HEALTH AND WELLNESS PLLC (NPI# 1396227609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396227609 |
| Entity Type | Organization |
| Organization Name | PHOENIX MENTAL HEALTH AND WELLNESS PLLC |
| Practice Address |
914 N San Francisco St Ste D Flagstaff AZ 86001-3254 |
| Mailing Address |
5551 S White Mountain Rd Unit 2 Show Low AZ 85901-7449 |
| Practice Telephone | 9289851495 |
| Practice Fax Number | 9855975198 |
| Mailing Telephone | 9289851495 |
| Mailing Fax Number | 9285975198 |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | LYNN COOPER JOHNSON (PMHNP) |
| Authorized Official Telephone | 9289851495 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP11496 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 580 E Old Linden Rd Ste 6, Show Low, AZ 859014817 | 9289851495 | 9285975198 |
| Street Address |
914 N SAN FRANCISCO ST STE D |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124318159 | Lynn Cooper Johnson | Registered Nurse | 914 N San Francisco St Ste D, Flagstaff, AZ 86001-3254 | 2011-04-11 |
| 1285269852 | Cameo Johnson Np, Pllc | Nurse Practitioner | 914 N San Francisco St Ste D, Flagstaff, AZ 86001-3254 | 2020-03-04 |
| 1518590553 | Cameo Elizabeth Johnson | Nurse Practitioner | 914 N San Francisco St Ste D, Flagstaff, AZ 86001-3254 | 2020-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750864252 | Stephen Evan Taylor | Nurse Practitioner | 1890 N Venus Dr, Flagstaff, AZ 86001-2503 | 2018-09-11 |
| 1902105661 | Joanne Ivy Isaacs | Nurse Practitioner | 620 1/2 W Birch Ave, Flagstaff, AZ 86001-4416 | 2011-03-21 |
| 1649334293 | Maria Margaret Denny | Nurse Practitioner | Fronske Health Ctr, P.o. 6033, Flagstaff, AZ 86011-0001 | 2006-12-20 |
| 1407829997 | Marsha J Ashurst | Nurse Practitioner | 2700 W Lynette Dr, Flagstaff, AZ 86001-1028 | 2006-02-07 |
| 1285269852 | Cameo Johnson Np, Pllc | Nurse Practitioner | 914 N San Francisco St Ste D, Flagstaff, AZ 86001-3254 | 2020-03-04 |
| 1518590553 | Cameo Elizabeth Johnson | Nurse Practitioner | 914 N San Francisco St Ste D, Flagstaff, AZ 86001-3254 | 2020-02-18 |
| 1215580469 | Rachel Bonvillain Josefchuk | Nurse Practitioner | 1515 E Cedar Ave Ste B-4, Flagstaff, AZ 86004-1645 | 2019-07-17 |
| 1508428368 | Rebecca Landon | Nurse Practitioner | 1338 W Forest Meadows St Ste 140, Flagstaff, AZ 86001-7226 | 2019-07-02 |
| 1912484437 | Joan Marie Moore | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2018-07-26 |
| 1962910760 | Phillip Casey Dubravcic | Nurse Practitioner | 2187 N Vickey St, Flagstaff, AZ 86004-6121 | 2018-01-15 |
| Find all providers in FLAGSTAFF | ||||
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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.