Healthcare Provider Details

I. General information

NPI: 1891319778
Provider Name (Legal Business Name): MARIA CAZARES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 COMMERCE DR
PRESCOTT AZ
86305-3700
US

IV. Provider business mailing address

1090 COMMERCE DR
PRESCOTT AZ
86305-3700
US

V. Phone/Fax

Practice location:
  • Phone: 928-583-1000
  • Fax:
Mailing address:
  • Phone: 928-583-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number63085
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22625
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: