Healthcare Provider Details

I. General information

NPI: 1619074358
Provider Name (Legal Business Name): DONNI T FLEISCHAKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 W PEORIA AVE STE D805
PHOENIX AZ
85029-4600
US

IV. Provider business mailing address

3201 W PEORIA AVE STE D805
PHOENIX AZ
85029-4600
US

V. Phone/Fax

Practice location:
  • Phone: 602-569-5437
  • Fax:
Mailing address:
  • Phone: 480-277-5743
  • Fax: 855-583-3686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17503
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number17503
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17503
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17503
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number17503
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17503
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: