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General NPI Number Information
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NPI Number | 1902156805
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Entity Type | Individual
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Provider Name | NOREEN A. CLANCY LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 3141 N 3RD AVE
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City | PHOENIX
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State | AZ
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Zip | 85013-4345
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Country | US
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Telephone | 602-406-6433
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Fax | 602-406-4270
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Provider Business Mailing Address
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Address Line | 2929 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85016-8034
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Country | US
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Telephone | 602-470-5043
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Fax | 602-470-5064
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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-1775
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License Number State | AZ
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