Healthcare Provider Details

I. General information

NPI: 1861860330
Provider Name (Legal Business Name): NOHEMI MACIEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2015
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3690 S PARK AVE STE 805
TUCSON AZ
85713-5042
US

IV. Provider business mailing address

PO BOX 188
MARANA AZ
85653-0188
US

V. Phone/Fax

Practice location:
  • Phone: 520-616-6760
  • Fax: 520-616-6799
Mailing address:
  • Phone: 520-616-6760
  • Fax: 520-616-6799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-18859
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: