Healthcare Provider Details

I. General information

NPI: 1306762471
Provider Name (Legal Business Name): PAIGE ELIZABETH MYRICK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 E CORONADO RD STE 201
PHOENIX AZ
85004-1583
US

IV. Provider business mailing address

6610 E UNIVERSITY DR UNIT 9
MESA AZ
85205-7609
US

V. Phone/Fax

Practice location:
  • Phone: 480-712-4600
  • Fax:
Mailing address:
  • Phone: 507-412-3721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23792
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: