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Organization
AZT GROUP LLC
Active
Organization
AZT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CARLISLE FNP-C (MANAGER)
(480) 219-7098
Entity
Organization
Contact information
Practice address
18456 N 25TH AVE, PHOENIX, AZ 85023-1213
(480) 219-7098
Mailing address
6635 W HAPPY VALLEY RD STE A104, GLENDALE, AZ 85310-2609
(480) 219-7098
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
—
—
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
—
NULL
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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