Provider Demographics
NPI:1346084951
Name:ANCHOR INTEGRATIVE PSYCHIATRY LLC
Entity type:Organization
Organization Name:ANCHOR INTEGRATIVE PSYCHIATRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:NDENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DERICK SALLE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, PMHNP-BC
Authorized Official - Phone:240-425-7240
Mailing Address - Street 1:2500 N PANTANO RD STE 2312
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3759
Mailing Address - Country:US
Mailing Address - Phone:520-704-7100
Mailing Address - Fax:520-704-4000
Practice Address - Street 1:2500 N PANTANO RD STE 2312
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3759
Practice Address - Country:US
Practice Address - Phone:520-704-7100
Practice Address - Fax:520-704-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty