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General NPI Number Information
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NPI Number | 1306047089
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Entity Type | Individual
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Provider Name | MASSOUMEH S. KAZEMI LPC, LISAC
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4222 E CAMELBACK RD SUITE H210
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City | PHOENIX
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State | AZ
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Zip | 85018-2745
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Country | US
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Telephone | 480-390-0998
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Fax |
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Provider Business Mailing Address
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Address Line | 6404 E BAR Z LN
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-1819
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Country | US
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Telephone | 480-390-0998
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC-10839
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-12214
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License Number State | AZ
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