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General NPI Number Information
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NPI Number | 1851583850
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Entity Type | Individual
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Provider Name | MARCY MEVORACH LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 05/28/2022
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Provider Practice Location Address
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Address Line | 8687 E VIA DE VENTURA STE 308
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3349
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Country | US
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Telephone | 480-707-2885
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Fax |
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Provider Business Mailing Address
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Address Line | 8687 E VIA DE VENTURA STE 308
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3349
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Country | US
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Telephone | 480-707-2885
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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 | 13047
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 7796
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 069203-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 2217623
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12488
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License Number State | AZ
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