Provider Demographics
NPI:1386385607
Name:VALLEY MENTAL HEALTH & PSYCHIATRIC SERVICES, LLC
Entity type:Organization
Organization Name:VALLEY MENTAL HEALTH & PSYCHIATRIC SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:DR
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:VMPS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-559-1215
Mailing Address - Street 1:2321 N ALSAP RD
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-1665
Mailing Address - Country:US
Mailing Address - Phone:602-399-0134
Mailing Address - Fax:
Practice Address - Street 1:1717 WEST NORTHERN AVE SUITE 107
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021
Practice Address - Country:US
Practice Address - Phone:480-559-1215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY MENTAL HEALTH & PSYCHIATRIC SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-02
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD02739924Medicaid