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General NPI Number Information
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NPI Number | 1568639649
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Entity Type | Individual
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Provider Name | KYRIE ANN CONSEEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 14050 N 83RD AVE STE 290
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City | PEORIA
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State | AZ
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Zip | 85381-5650
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Country | US
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Telephone | 480-349-1031
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Fax | 480-535-1510
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Provider Business Mailing Address
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Address Line | 14050 N 83RD AVE STE 290
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City | PEORIA
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State | AZ
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Zip | 85381
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Country | US
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Telephone | 480-349-1031
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-12376
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License Number State | AZ
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