- Practice location
- 544 S 96TH Pl, Mesa, AZ 85208-2512
- Phone
- 480-696-0338
- Fax
- —
- Last updated
- June 3, 2021
Teen Out Reach Services is a healthcare organization based in Mesa, AZ. Teen Out Reach Services practices in Mesa, AZ. The NPI Number for Teen Out Reach Services is 1982289062. The current practice location address for Teen Out Reach Services is 544 S 96TH Pl, Mesa, AZ 85208-2512 and can be reached out via phone at 480-696-0338.
Provider Profile Details
- NPI Number
- 1982289062
- Provider Name
- Teen Out Reach Services
- Provider Entity Type
- Organization
- Address
- 544 S 96TH Pl, Mesa, AZ 85208-2512
- Phone Number
- 480-696-0338
- Primary Taxonomy
- Psychologist · 103T00000X
- Organization Subpart
- Yes
- Parent Organization
- Banner Health
- Authorized Official
- Amanda Reane Johnson, MD · Director · 480-696-0338
- Other Names
- Teen Out Reach Services (Doing Business As)
- Provider Enumeration Date
- March 10, 2021
- Last Update Date
- June 3, 2021
- Certification Date
- June 3, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 544 S 96TH Pl
Mesa, AZ 85208-2512 - City
- Mesa
- State
- Arizona
- Zip
- 85208-2512
- Phone Number
- 480-696-0338
Provider Business Mailing Address Details
- Address
- 544 S 96TH Pl Apt 2080
Mesa, AZ 85208-2512 - City
- Mesa
- State
- AZ
- Zip
- 85208-2512
- Phone Number
- 480-696-0338
License Information
- Taxonomy (1)
- General Acute Care Hospital, Critical Access · 282NC0060X
- Taxonomy (2)
- Psychologist · 103T00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Teen Out Reach Services?
The NPI number of Teen Out Reach Services is 1982289062. It was assigned on March 10, 2021 and is currently active in the NPPES registry.
What is the specialty of Teen Out Reach Services?
Teen Out Reach Services is registered under the primary taxonomy Psychologist (code 103T00000X).
Where does Teen Out Reach Services practice?
The practice location is 544 S 96TH Pl, Mesa, AZ 85208-2512. The office can be reached at 480-696-0338 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1982289062 directly on the NPPES registry website.