Provider Demographics
NPI:1447943683
Name:ADVANTAGE ADHD & PSYCHIATRY SERVICES
Entity type:Organization
Organization Name:ADVANTAGE ADHD & PSYCHIATRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:VALERIE
Authorized Official - Last Name:LEONHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:480-310-2924
Mailing Address - Street 1:3271 E QUEEN CREEK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8511
Mailing Address - Country:US
Mailing Address - Phone:480-550-3194
Mailing Address - Fax:
Practice Address - Street 1:3271 E QUEEN CREEK RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8511
Practice Address - Country:US
Practice Address - Phone:480-550-3194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty