Provider Demographics
NPI:1306417258
Name:BRINK, JARED (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:BRINK
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16430 N SCOTTSDALE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1581
Mailing Address - Country:US
Mailing Address - Phone:602-266-8700
Mailing Address - Fax:602-646-8901
Practice Address - Street 1:2550 W UNION HILLS DR STE 350
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-5187
Practice Address - Country:US
Practice Address - Phone:623-295-9026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ260271363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health