Organization
BLACK MOUNTAIN BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONSTANTINOS DIMITRIOS THOMOPOULOS PSYD (EXECUTIVE DIRECTOR)
(480) 595-1555
Entity
Organization
Contact information
Practice address
33755 N SCOTTSDALE RD, SUITE J-105, SCOTTSDALE, AZ 85266-1567
(480) 595-1555
(866) 307-0007
Mailing address
33755 N SCOTTSDALE RD, SUITE J-105, SCOTTSDALE, AZ 85266-1567
(480) 595-1555
(866) 307-0007
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2014
Last updated
05/08/2014
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