Provider Demographics
NPI:1164307146
Name:JOSEPH, LALI MANTHARAIL (PMHNP)
Entity type:Individual
Prefix:MS
First Name:LALI
Middle Name:MANTHARAIL
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 W SAN CARLOS WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-5173
Mailing Address - Country:US
Mailing Address - Phone:602-300-2735
Mailing Address - Fax:
Practice Address - Street 1:693 W SAN CARLOS WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-5173
Practice Address - Country:US
Practice Address - Phone:602-300-2735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ316502363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health