=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467217745
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ISAAC MICHAEL AKAPNITIS LMSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2024
-----------------------------------------------------
Last Update Date | 02/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 W ROOSEVELT ST
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85003-1324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-695-7980
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2115 W PICCADILLY RD
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85015-5358
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-351-5978
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | LMSW-13996
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------