# PRESTIGE PSYCHIATRIC PROFESSIONALS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prestige Psychiatric Professionals
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437682614
- **Authorized official:** MR. PAUL ERIC LARRALDE PMHNP-BC (MEMBER)
- **Authorized official phone:** (602) 910-6519

## Contact information

- **Practice address:** 8414 E SHEA BLVD, SUITE 102, SCOTTSDALE, AZ 85260-6665
- **Practice address phone:** (602) 910-6519
- **Practice address fax:** (602) 910-6519
- **Mailing address:** 3120 W CAREFREE HWY, STE 1-602, PHOENIX, AZ 85086-3201
- **Mailing address phone:** (602) 910-6519
- **Mailing address fax:** (602) 910-6519

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LISAC-11647 | AZ | — |
| 101YP2500X | Professional Counselor | LPC-11774 | AZ | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | RN147893 | AZ | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP5217 | AZ | Yes |

## Other

- **Enumeration date:** 04/05/2017
- **Last updated:** 04/05/2017