Healthcare Provider Details

I. General information

NPI: 1184031452
Provider Name (Legal Business Name): CHAD REILY METZ LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1148 W BASELINE RD
MESA AZ
85210-5971
US

IV. Provider business mailing address

1257 W DEXTER WAY
SAN TAN VALLEY AZ
85143-5448
US

V. Phone/Fax

Practice location:
  • Phone: 480-749-8898
  • Fax:
Mailing address:
  • Phone: 480-749-8898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21798
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: