CONNECT MENTAL HEALTH AND WELLNESS, LLC
NPI 1922785567
Nurse Practitioner - Psychiatric/Mental Health in Surprise, AZ

Q: What is Connect Mental Health And Wellness, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since July 04, 2023

12301 W BELL RD STE A102, SURPRISE, AZ 85378(407) 473-1137(407) 650-3450 Get Directions Write a Review

NPPES record last updated: July 4, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Connect Mental Health And Wellness, Llc NPPES

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

CONNECT MENTAL HEALTH AND WELLNESS, LLC (NPI 1922785567) is a healthcare organization registered as a psychiatric/mental health in Surprise, Arizona and active in the NPI registry since July 2023. The organization lists Amy M Porter, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1922785567

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameCONNECT MENTAL HEALTH AND WELLNESS, LLC

Location Address12301 W BELL RD STE A102Surprise, AZ 85378-9707

Mailing Address1846 E Innovation Park Dr Ste 100Oro Valley, AZ 85755-1963 · (407) 473-1137 · Fax (407) 650-3450

Phone(407) 473-1137

Fax(407) 650-3450

Organization SubpartNo

Authorized OfficialAmy M PorterCo-owner · (407) 473-1137

Enumeration DateJuly 4, 2023

NPPES CertifiedJuly 4, 2023

✔ NPI 1922785567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

12301 W BELL RD STE A102, Surprise, AZ 85378

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Connect Mental Health And Wellness, 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 Connect Mental Health And Wellness, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Chad Jacobs, PMHNP

Nurse Practitioner

NPI 1336783893

21907 64TH AVE W STE 200
Mountlake Terrace, WA 98043

(317) 695-8041

✔ PECOS1,107 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 Connect Mental Health And Wellness, LLC's NPI number?

The NPI number for Connect Mental Health And Wellness, LLC is 1922785567. It was assigned to this organization in the NPPES registry on July 4, 2023.

Where is Connect Mental Health And Wellness, LLC located?

Connect Mental Health And Wellness, LLC is located at 12301 W Bell Rd Ste A102, Surprise, AZ 85378. The listed phone number is (407) 473-1137.

What is Connect Mental Health And Wellness, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Connect Mental Health And Wellness, LLC enrolled in Medicare?

Yes. Connect Mental Health And Wellness, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Connect Mental Health And Wellness, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Connect Mental Health And Wellness, 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 Connect Mental Health And Wellness, LLC was last updated on July 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.