Provider Demographics
NPI:1205302270
Name:PSYCH ZENHEALTH PLLC
Entity type:Organization
Organization Name:PSYCH ZENHEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSIAH
Authorized Official - Middle Name:NNADOZIE
Authorized Official - Last Name:NWAOKWA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:623-225-7591
Mailing Address - Street 1:1095 E INDIAN SCHOOL RD STE 700
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4846
Mailing Address - Country:US
Mailing Address - Phone:623-225-7591
Mailing Address - Fax:623-230-3726
Practice Address - Street 1:1095 E INDIAN SCHOOL RD STE 700
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4846
Practice Address - Country:US
Practice Address - Phone:623-225-7591
Practice Address - Fax:623-230-3726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ223013Medicaid