WISTERIA MENTAL HEALTH & WELLNESS CENTER PLLC
NPI 1194413419
Psychiatry & Neurology - Child & Adolescent Psychiatry in Phoenix, AZ

Q: What is Wisteria Mental Health & Wellness Center PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Active since April 25, 2023

301 W ECHO LN, PHOENIX, AZ 85021(480) 399-8455(866) 845-1832 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 14, 2025, Nov 12, 2024, May 8, 2023 (3 updates tracked since 2023).

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About Wisteria Mental Health & Wellness Center Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WISTERIA MENTAL HEALTH & WELLNESS CENTER PLLC (NPI 1194413419) is a healthcare organization registered as a child & adolescent psychiatry in Phoenix, Arizona and active in the NPI registry since April 2023. The organization lists Roberto Igor Bracamonte Valencia, Ceo, as its authorized official.

NPPES Registry Identity

NPI1194413419

Entity TypeOrganization

Primary Taxonomy2084P0804X

Legal Business NameWISTERIA MENTAL HEALTH & WELLNESS CENTER PLLC

Location Address301 W ECHO LNPhoenix, AZ 85021-5554

Mailing Address14802 N 18th PlPhoenix, AZ 85022-3925 · (480) 399-8455 · Fax (866) 845-1832

Phone(480) 399-8455

Fax(866) 845-1832

Organization SubpartNo

Authorized OfficialRoberto Igor Bracamonte ValenciaCeo · (602) 350-3046

Enumeration DateApril 25, 2023

Last NPPES UpdateMarch 14, 20253 updates tracked since enumeration

NPPES CertifiedMarch 14, 2025

✔ NPI 1194413419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

301 W ECHO LN, Phoenix, AZ 85021

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERTO IGOR BRACAMONTE VALENCIA M.D.

Psychiatry & Neurology (Child & Adolescent Psychiatry)

301 W ECHO LN
PHOENIX, AZ 85021

Maricopa County (602) 350-3046

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wisteria Mental Health & Wellness Center PLLC's NPI number?

The NPI number for Wisteria Mental Health & Wellness Center PLLC is 1194413419. It was assigned to this organization in the NPPES registry on April 25, 2023.

Where is Wisteria Mental Health & Wellness Center PLLC located?

Wisteria Mental Health & Wellness Center PLLC is located at 301 W Echo Ln, Phoenix, AZ 85021. The listed phone number is (480) 399-8455.

What is Wisteria Mental Health & Wellness Center PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

When was this NPI record last updated?

The NPPES record for Wisteria Mental Health & Wellness Center PLLC was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.