PRONGHORN PSYCHIATRY (NPI# 1700377983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700377983 |
| Entity Type | Organization |
| Organization Name | PRONGHORN PSYCHIATRY |
| Other Organization Name | STONERIDGE CENTERS FOR BRAIN AND ADDICTION TREATMENT |
| Practice Address |
5940 E. Copper Hill Dr Suite E Prescott Valley AZ 86314 |
| Practice Telephone | 9285837799 |
| Practice Fax Number | 9285837891 |
| Mailing Telephone | 9285837799 |
| Mailing Fax Number | 9285837891 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |
| Authorized Official Name | BARBARA THOMPSON (CHIEF INFORMATION OFFICER) |
| Authorized Official Telephone | 9285837799 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
OTC8169 | AZ | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Stoneridge Centers for Brain and Addiction Treatment | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922401496 | Pronghorn Psychiatry | Psychiatric Hospital | 5940 E. Copper Hill Dr., Ste. B, Prescott Valley, AZ 86314 | 2014-09-29 |
| Street Address |
5940 E. COPPER HILL DR SUITE E |
| City | PRESCOTT VALLEY |
| State | AZ |
| Zip Code | 86314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992326029 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 3001 N. Mountain View Rd, Prescott Valley, AZ 86314 | 2020-04-29 |
| 1124666516 | Best Care Behavioral Homes LLC | Community/Behavioral Health | 5385 W Saddleback Drive, Prescott Valley, AZ 86314 | 2019-12-16 |
| 1912541558 | The Stateserv Companies, LLC | Durable Medical Equipment & Medical Supplies | 8926 E. Long Mesa Drive, Prescott Valley, AZ 86314 | 2019-11-06 |
| 1003398983 | Richard Telck | Pharmacist | 7720 E. Highway 69, Prescott Valley, AZ 86314 | 2018-09-06 |
| 1912493065 | Akdhc,llc | Internal Medicine | 7862 E Florentine Rd, Suite 120, Prescott Valley, AZ 86314 | 2018-07-02 |
| 1689185126 | Thumb Butte Urgent Care | Clinic/Center | 6496 East Highway 69, Prescott Valley, AZ 86314 | 2017-10-23 |
| 1740738046 | Janine Kauffmann | Pharmacist | 7720 East Highway 69, Prescott Valley, AZ 86314 | 2016-09-14 |
| 1528415650 | Nazcare, Inc. | Exclusive Provider Organization | 8200 E. Jacque Dr., Prescott Valley, AZ 86314 | 2016-05-18 |
| 1184087009 | William Beverly | Marriage & Family Therapist | 8603 E. Eastridge Dr., Ste A, Prescott Valley, AZ 86314 | 2016-03-29 |
| 1164803433 | Nicole Scott | Specialist | 8603 E. Eastridge Drive, Suite A, Prescott Valley, AZ 86314 | 2015-06-12 |
| Find all providers in zip 86314 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841527546 | Rory B. Madden, Ed.d., PC | Clinic/Center | 7915 N Paradise Canyon Ln, Prescott Valley, AZ 86315-9098 | 2009-11-17 |
| 1750743688 | West Yavapai Guidance Clinic Inc | Clinic/Center | 3075 N Windsong Dr, Prescott Valley, AZ 86314-1208 | 2016-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497372908 | A Path of Resilience - Aprbhs - Rose House - LLC | Clinic/Center | 2258 W Wayland Rd, Phoenix, AZ 85041-3753 | 2020-06-30 |
| 1083237630 | The Heart Program | Clinic/Center | 4041 E Flower St, Phoenix, AZ 85018-6433 | 2020-05-18 |
| 1316569056 | Desert Heart Counseling Corp | Clinic/Center | 1536 E Maryland Ave Ste B300, Phoenix, AZ 85014-1475 | 2020-05-16 |
| 1922638055 | Lotus Health Arizona | Clinic/Center | 2600 E Southern Ave Ste I3, Tempe, AZ 85282-7738 | 2020-01-16 |
| 1689218687 | Devine Momentum Phoenix | Clinic/Center | 15342 W Turney Ave, Goodyear, AZ 85395-6323 | 2019-11-01 |
| 1588212195 | Tamarria Denga | Clinic/Center | 10000 N 31st Ave Ste D411, Phoenix, AZ 85051-1358 | 2019-08-27 |
| 1932768975 | Evolve Counseling & Behavioral Health Services | Clinic/Center | 1206 E Warner Rd # 203, Gilbert, AZ 85296-3132 | 2019-06-12 |
| 1073171153 | Heart Song Wellness LLC | Clinic/Center | 8617 W Union Hills Dr Ste 100, Peoria, AZ 85382-7001 | 2019-06-03 |
| 1659936680 | Sedona Family Counseling | Clinic/Center | 130 Castle Rock Rd Unit 65, Sedona, AZ 86351-8876 | 2019-05-06 |
| 1043778756 | Aye Wellness, Pllc | Clinic/Center | 2406 S 24th St Ste E100, Phoenix, AZ 85034-6801 | 2019-03-12 |
| Find all providers with the same taxonomy | ||||
| City | PRESCOTT VALLEY |
| Zip Code | 86314 |
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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.