ESTRELLA MENTAL HEALTH SERVICES PLLC NPI 1376122184

NPI Information

NPI: 1376122184
Provider Name: ESTRELLA MENTAL HEALTH SERVICES, PLLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 03D2052491

Address:
12725 W INDIAN SCHOOL RD STE E101
AVONDALE, AZ
ZIP 85392
Phone: (623) 640-7682
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ESTRELLA MENTAL HEALTH SERVICES, PLLC is a psychiatric/mental health nurse practitioner in Avondale, AZ. ESTRELLA MENTAL HEALTH SERVICES, PLLC NPI is 1376122184. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12725 W INDIAN SCHOOL RD STE E101
AVONDALE, AZ
ZIP 85392-525
Phone: (623) 640-7682
Fax: (855) 932-1312

The provider's authorized official is Daryl Ian Cotton .
The authorized official title is Owner/ceo and has the following contact phone number (623) 640-7682.

The CLIA number assigned to this NPI record is 03D2052491 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2021 and was last updated on 6/10/2022.

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	License Number	License State	Primary
1	101YP2500X	Counselor	Professional			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			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: 4/28/2024

NPI Synchronization or Removal

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