# ACT MENTAL HEALTH SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992285852
- **Authorized official:** MS. JUNE ANN STALEY PMHNP-BC (PRESIDENT)
- **Authorized official phone:** (855) 647-4228

## Contact information

- **Practice address:** 30 ACOMA BLVD S, LAKE HAVASU CITY, AZ 86403-5957
- **Practice address phone:** (855) 647-4228
- **Mailing address:** 2924 PONY DR, LAKE HAVASU CITY, AZ 86406-8432
- **Mailing address phone:** (507) 380-7218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2018
- **Last updated:** 08/20/2018