ACT MENTAL HEALTH SERVICES, LLC (NPI# 1992285852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992285852 |
| Entity Type | Organization |
| Organization Name | ACT MENTAL HEALTH SERVICES, LLC |
| Practice Address |
30 Acoma Blvd S Lake Havasu City AZ 86403-5957 |
| Mailing Address |
2924 Pony Dr Lake Havasu City AZ 86406-8432 |
| Practice Telephone | 8556474228 |
| Mailing Telephone | 5073807218 |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |
| Authorized Official Name | MS. JUNE ANN STALEY (PRESIDENT) |
| Authorized Official Telephone | 8556474228 |
| Authorized Official Credential | PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
30 ACOMA BLVD S |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619903986 | Mediterranean Mental Health Center, Inc. | Psychiatry & Neurology | 30 Acoma Blvd S, 101-103, Lake Havasu City, AZ 86403-5957 | 2006-06-25 |
| 1689809600 | Mirta I Kaperonis | Counselor | 30 Acoma Blvd S, Suite101-103, Lake Havasu City, AZ 86403-5957 | 2009-05-19 |
| 1124214093 | Vasilios W Kaperonis | Psychiatry & Neurology | 30 Acoma Blvd S, #101-103, Lake Havasu City, AZ 86403-5957 | 2007-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| 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 |
|---|---|---|---|---|
| 1184091845 | June Staley | Nurse Practitioner | 1845 Mcculloch Blvd N, Suite B-1, Lake Havasu City, AZ 86403-6759 | 2015-08-28 |
| 1902041551 | Sharon L Gala | Nurse Practitioner | 2187 Swanson Ave, Lake Havasu City, AZ 86403-6838 | 2008-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608447 | Courtney Tafoya | Nurse Practitioner | 544 S 172nd Ave, Goodyear, AZ 85338-1281 | 2020-10-26 |
| 1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
| 1871191593 | Lisa E Legg | Nurse Practitioner | 1480 E Pecos Rd Apt 3107, Gilbert, AZ 85295-1851 | 2020-10-14 |
| 1619584406 | Preston Strebeck | Nurse Practitioner | 3733 E Meadow Mist Ln, San Tan Valley, AZ 85140-5374 | 2020-09-25 |
| 1336754332 | Yvonne Maese | Nurse Practitioner | 824 N 99th Ave Ste 107-108, Avondale, AZ 85323-5324 | 2020-09-15 |
| 1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
| 1215549274 | Maria Graciela Cornejo | Nurse Practitioner | 3421 S Loback Ln, Gilbert, AZ 85297-7913 | 2020-08-20 |
| 1013529155 | Mark Skousen | Nurse Practitioner | 1745 W Western Dove Dr, Snowflake, AZ 85937-6185 | 2020-08-19 |
| 1356953699 | Rebecca Jane Turley | Nurse Practitioner | 1681 S Villas Ln, Chandler, AZ 85286-6805 | 2020-08-18 |
| 1467064063 | Dylan O'keefe Carey | Nurse Practitioner | 11702 W Fordson Dr, Marana, AZ 85653-7715 | 2020-08-17 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on ACT MENTAL HEALTH SERVICES, LLC.
| 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.