MY BROTHERS KEEPER NPI 1205600541

NPI Information

NPI: 1205600541
Provider Name: MY BROTHERS KEEPER
Classification: Peer Specialist - 175T00000X
Entity Type: Organization
Other Name: MBK
Address: 4425 E AGAVE RD STE 102
PHOENIX, AZ
ZIP 85044
Phone: (480) 265-8816

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NPI Details

MY BROTHERS KEEPER is a peer specialist in Phoenix, AZ. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. MY BROTHERS KEEPER NPI is 1205600541. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Mbk.

The provider's business location address is:

4425 E AGAVE RD STE 102
PHOENIX, AZ
ZIP 85044-620
Phone: (480) 265-8816

The provider's authorized official is Jacqueline Perrie .
The authorized official title is Administrator and has the following contact phone number (480) 265-8816.

The enumeration date for this NPI number is 11/7/2023 and was last updated on 11/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101200000X	Drama Therapist		No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
3	101YM0800X	Counselor	Mental Health	No
4	101YP1600X	Counselor	Pastoral	No
5	101YP2500X	Counselor	Professional	No
6	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	No
7	171M00000X	Case Manager/Care Coordinator		No
8	172A00000X	Driver		No
9	177F00000X	Lodging		No
10	251B00000X	Case Management		No
11	251S00000X	Community/Behavioral Health		No
12	252Y00000X	Early Intervention Provider Agency		No
13	347C00000X	Private Vehicle		No
14	405300000X	Prevention Professional		No
15	175T00000X	Peer Specialist		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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