Healthcare Provider Details

I. General information

NPI: 1417413857
Provider Name (Legal Business Name): BRANDON BRIZEL LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 N SCOTTSDALE RD STE C
SCOTTSDALE AZ
85257-4207
US

IV. Provider business mailing address

881 N MADRID LN
CHANDLER AZ
85226-2344
US

V. Phone/Fax

Practice location:
  • Phone: 480-579-3910
  • Fax:
Mailing address:
  • Phone: 480-335-1750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMSW-08310T
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-08310T
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: