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NPI Code Detail

MEDICARE: ARIZONA DEVELOPMENTAL PSYCHOLOGY

MEDICARE: ARIZONA DEVELOPMENTAL PSYCHOLOGY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2103TB0200XCognitive & Behavioral Psychologist
3103TC1900XCounseling Psychologist
4103T00000XPsychologist

General Provider Information

NPI Number : 1972449007
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA DEVELOPMENTAL PSYCHOLOGY
Provider Business Mailing Address
First Line : 11431 N 39TH PL
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-2102
Country : US
Telephone Number : 602-675-3288
Fax Number :
Provider Business Practice Location Address
First Line : 3420 E SHEA BLVD STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-3348
Country : US
Telephone Number : 602-675-3288
Fax Number :
Authorized Official
Title or Position : OWNER/FOUNDER
Name : AMANDA AARON HACKWELL
Credential :
Telephone Number : 602-675-3288
Provider Enumeration Date : 04/29/2026
Last Update Date : 04/29/2026

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Directions to “ARIZONA DEVELOPMENTAL PSYCHOLOGY ” Practice Location

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