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General NPI Number Information
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NPI Number | 1508859190
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Entity Type | Individual
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Provider Name | MICHAEL JAY TRAUB MSW, LCSW, ACSW, MBA
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Gender | Male
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 10587 E SALT BUSH DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-1901
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Country | US
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Telephone | 480-515-0490
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Fax | 480-515-0015
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Provider Business Mailing Address
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Address Line | 10587 E SALT BUSH DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-1901
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Country | US
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Telephone | 480-515-0490
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Fax | 480-515-0015
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW1731
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License Number State | AZ
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