CANYON HAVEN PSYCHIATRY LLC
NPI 1275488082
Nurse Practitioner - Psychiatric/Mental Health in Glendale, AZ
About Canyon Haven Psychiatry Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CANYON HAVEN PSYCHIATRY LLC (NPI 1275488082) is a healthcare organization registered as a psychiatric/mental health in Glendale, Arizona and active in the NPI registry since February 2026. The organization lists Mary Waweru, Owner Of Entity, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Canyon Haven Psychiatry Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Canyon Haven Psychiatry LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Canyon Haven Psychiatry LLC's NPI number?
The NPI number for Canyon Haven Psychiatry LLC is 1275488082. It was assigned to this organization in the NPPES registry on February 27, 2026.
Where is Canyon Haven Psychiatry LLC located?
Canyon Haven Psychiatry LLC is located at 6120 W Bell Rd Ste 100A, Glendale, AZ 85308. The listed phone number is (480) 999-5114.
What is Canyon Haven Psychiatry LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Canyon Haven Psychiatry LLC enrolled in Medicare?
Yes. Canyon Haven Psychiatry LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Canyon Haven Psychiatry LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Canyon Haven Psychiatry LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Canyon Haven Psychiatry LLC was last updated on February 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Canyon Haven Psychiatry Llc · NPI 1275488082
Psychiatric/Mental Health organization in Glendale, Arizona. Organization record, active in the CMS NPPES registry since February 27, 2026.
## Identity
- **NPI:** 1275488082 (Entity type: Organization)
- **Enumerated:** February 27, 2026
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Mary Waweru, OWNER OF ENTITY
## Practice location
- **Address:** 6120 W BELL RD STE 100A, Glendale, AZ 85308-3780
- **Phone:** (480) 999-5114 · **Fax:** (480) 459-3339
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 27, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1275488082) · Data from the CMS NPPES public registry.