Healthcare Provider Details

I. General information

NPI: 1447375019
Provider Name (Legal Business Name): ARTHUR ALEXANDER SIRIANNI M.S.W
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 W SWAN PL
CHANDLER AZ
85286-5152
US

IV. Provider business mailing address

1670 W SWAN PL
CHANDLER AZ
85286-5152
US

V. Phone/Fax

Practice location:
  • Phone: 480-244-3369
  • Fax:
Mailing address:
  • Phone: 480-244-3369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLISAC-1423
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1143816
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW- 4111
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: