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NPI Code Detail

MEDICARE: MS. EWA BOXER MS, LPC, LISAC

MEDICARE: MS. EWA BOXER MS, LPC, LISAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLISAC-11514AZ
2101YP2500XProfessional CounselorLPC-1495AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225299878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EWA BOXER MS, LPC, LISAC
Provider Business Mailing Address
First Line : 3003 N CENTRAL AVE
Second Line : SUITE 200
City : PHOENIX
State : AZ
Zip : 85012-2902
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-302-7925
Provider Business Practice Location Address
First Line : 1802 E THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-8134
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-258-6140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2008
Last Update Date : 12/08/2016

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