Healthcare Provider Details

I. General information

NPI: 1659071900
Provider Name (Legal Business Name): STASEE J MCBRIDE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E BASELINE RD STE D205
TEMPE AZ
85283-1298
US

IV. Provider business mailing address

1776 N SCOTTSDALE RD UNIT 601
SCOTTSDALE AZ
85252-3626
US

V. Phone/Fax

Practice location:
  • Phone: 480-490-3545
  • Fax:
Mailing address:
  • Phone: 480-490-3545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-23119
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: