TEEN OUT REACH SERVICES
NPI 1982289062
Psychologist in Mesa, AZ

Active since March 10, 2021

NPPES record last updated: June 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 3, 2021, Mar 14, 2021 (2 updates tracked since 2021).

About Teen Out Reach Services NPPES

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

TEEN OUT REACH SERVICES (NPI 1982289062) is a healthcare organization registered as a psychologist in Mesa, Arizona and active in the NPI registry since March 2021. The organization maintains 4 additional practice locations and lists Amanda Reane Johnson, Director, as its authorized official.

NPPES Registry Identity

NPI1982289062
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameTEEN OUT REACH SERVICES
Location Address544 S 96TH PLMesa, AZ 85208-2512
Mailing Address544 S 96th Pl Apt 2080Mesa, AZ 85208-2512 · (480) 696-0338
Organization SubpartYesParent: Banner Health
Authorized OfficialAmanda Reane JohnsonDirector · (480) 696-0338
Enumeration DateMarch 10, 2021
Last NPPES UpdateJune 3, 20212 updates tracked since enumeration
NPPES CertifiedJune 3, 2021
NPI 1982289062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
544 S 96TH PL, Mesa, AZ 85208

Other Names 1

Doing Business AsTeen Out Reach Services

Secondary Practice Locations 4

Location 1401 E High StCharlottesville, VA 22902-5119 · Phone (480) 696-0338
Location 21 Ashburton PlBoston, MA 02108-1518 · Phone (480) 696-0338
Location 35600 Fishers LnRockville, MD 20852-1750 · Phone (480) 696-0338
Location 44600 N Wyandotte StKansas City, MO 64116-1518 · Phone (480) 696-0338

Other Identifiers 1

Medicaid282NC0060XAZ

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.

Behavior Analyst
544 S 96TH PL
MESA, AZ 85208

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 Teen Out Reach Services's NPI number?

The NPI number for Teen Out Reach Services is 1982289062. It was assigned to this organization in the NPPES registry on March 10, 2021.

Where is Teen Out Reach Services located?

Teen Out Reach Services is located at 544 S 96th Pl, Mesa, AZ 85208. The listed phone number is (480) 696-0338.

What is Teen Out Reach Services's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Teen Out Reach Services was last updated on June 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.