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BANNER TELEHEALTH LLC
NPI 1386352714
Clinic/Center - Mental Health (Including Community Mental Health Center) in Tucson, AZ

Active since November 15, 2022
1625 N CAMPBELL AVE, TUCSON, AZ 85719(520) 694-0111(520) 694-4805 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 2, 2025, Nov 15, 2022 (2 updates tracked since 2022).

About Banner Telehealth Llc NPPES

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

BANNER TELEHEALTH LLC (NPI 1386352714) is a healthcare organization registered as a mental health (including community mental health center) in Tucson, Arizona and active in the NPI registry since November 2022. The organization maintains a secondary practice location in Tucson and lists Todd Werner, Division President, as its authorized official.

NPPES Registry Identity

NPI1386352714
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameBANNER TELEHEALTH LLC
Location Address1625 N CAMPBELL AVETucson, AZ 85719-4330
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Phone(520) 694-0111
Fax(520) 694-4805
Organization SubpartYesParent: Banner Health
Authorized OfficialTodd WernerDivision President · (602) 747-4000
Enumeration DateNovember 15, 2022
Last NPPES UpdateSeptember 2, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2025
✔ NPI 1386352714 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
1625 N CAMPBELL AVE, Tucson, AZ 85719
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Secondary Practice Location 1

Location 12800 E Ajo WayTucson, AZ 85713-6204 · Phone (520) 874-2000

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Banner Telehealth Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

13

Medicare enrollment records show 13 clinicians reassign Medicare billing to Banner Telehealth LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians by Medicare Specialty 2

Clinical Social Worker12
Mental Health Counselor1

Clinicians, nearest first (13)

Nicole Carlson, LCSW, PMHNP-BC
Clinical Social Worker
NPI 1427556240
2600 E SOUTHERN AVE STE C3
Tempe, AZ 85282
(626) 515-8875
✔ PECOS96 mi
Jaclyn Grajewski
Clinical Social Worker
NPI 1376106294
525 W BROWN RD
Mesa, AZ 85201
(480) 684-8345
✔ PECOS✔ Accepts Medicare97 mi
Sean Mccarthy, LMSW
Clinical Social Worker
NPI 1134784895
525 W BROWN RD
Mesa, AZ 85201
(480) 684-8345
✔ PECOS✔ Accepts Medicare97 mi
Lisa Mckirchy, LCSW
Clinical Social Worker
NPI 1881218212
525 W BROWN RD
Mesa, AZ 85201
(602) 747-4772
✔ PECOS✔ Accepts Medicare97 mi
Felisha Hudson, LCSW
Clinical Social Worker
NPI 1811376338
2120 S MCCLINTOCK DR STE. 105
Tempe, AZ 85282
(480) 804-0326
✔ PECOS✔ Accepts Medicare98 mi
Parris Watson, MSW, LCSW
Clinical Social Worker
NPI 1144767252
2120 S MCCLINTOCK DR STE 105
Tempe, AZ 85282
(480) 804-0326
✔ PECOS98 mi
Amy Latham, LMSW
Clinical Social Worker
NPI 1528452984
2120 S MCCLINTOCK DR SUITE 105
Tempe, AZ 85282
(480) 804-0326
✔ PECOS✔ Accepts Medicare98 mi
Zachary Antil, LCSW
Clinical Social Worker
NPI 1851879068
7575 E EARLL DR STE 101
Scottsdale, AZ 85251
(480) 684-8345
✔ PECOS✔ Accepts Medicare102 mi
Johnna Hrovat, LIAC
Mental Health Counselor
NPI 1689276941
7575 E EARLL DR STE 101
Scottsdale, AZ 85251
(480) 684-8345
✔ PECOS102 mi
Kelly Kelley, MSW
Clinical Social Worker
NPI 1811060924
1300 N 12TH ST
Phoenix, AZ 85006
(602) 839-3927
✔ PECOS✔ Accepts Medicare106 mi
Kimberly Noll, LCSW
Clinical Social Worker
NPI 1215264221
1415 N 1ST ST
Phoenix, AZ 85004
(602) 685-6000
✔ PECOS✔ Accepts Medicare107 mi
Stephanie Henry
Clinical Social Worker
NPI 1033654272
6726 W BROWN ST
Peoria, AZ 85345
(623) 570-2140
✔ PECOS118 mi
Margaret Comford, MSW
Clinical Social Worker
NPI 1750335394
4500 STELLAR DR STE 104
Columbia, MO 65201
(833) 637-9236
✔ PECOS✔ Accepts Medicare1,142 mi

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 Banner Telehealth LLC's NPI number?

The NPI number for Banner Telehealth LLC is 1386352714. It was assigned to this organization in the NPPES registry on November 15, 2022.

Where is Banner Telehealth LLC located?

Banner Telehealth LLC is located at 1625 N Campbell Ave, Tucson, AZ 85719. The listed phone number is (520) 694-0111.

What is Banner Telehealth LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Banner Telehealth LLC enrolled in Medicare?

Yes. Banner Telehealth LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Banner Telehealth LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 2 Medicare specialties reassign their Medicare billing to Banner Telehealth 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. The largest specialties are Clinical Social Worker (12) and Mental Health Counselor (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Banner Telehealth LLC was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.