Provider Demographics
NPI:1710340302
Name:PSYCH UNLIMITED PLLC
Entity Type:Organization
Organization Name:PSYCH UNLIMITED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES DAGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-480-8054
Mailing Address - Street 1:3116 S MILL AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-3657
Mailing Address - Country:US
Mailing Address - Phone:622-382-6930
Mailing Address - Fax:866-761-1196
Practice Address - Street 1:6350 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2857
Practice Address - Country:US
Practice Address - Phone:480-345-5420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ477372084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty