Healthcare Provider Details

I. General information

NPI: 1013059633
Provider Name (Legal Business Name): IRA DRESSNER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 W VERNON AVE UNIT 518
PHOENIX AZ
85003-0010
US

IV. Provider business mailing address

17 W VERNON AVE UNIT 518
PHOENIX AZ
85003-0010
US

V. Phone/Fax

Practice location:
  • Phone: 623-523-9987
  • Fax: 888-343-2533
Mailing address:
  • Phone: 623-523-9987
  • Fax: 888-343-2533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-12226
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: