MEDICARE: MICHAEL PELAEZ LAMFT-T

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
1	106H00000X	Marriage & Family Therapist	LAMFT-08156T	AZ

General Provider Information

NPI Number	:	1265163950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PELAEZ LAMFT-T

Provider Business Mailing Address
First Line	:	7227 N 16TH ST STE 219
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-5257
Country	:	US
Telephone Number	:	602-492-7150
Fax Number	:

Provider Business Practice Location Address
First Line	:	7227 N 16TH ST STE 219
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-5257
Country	:	US
Telephone Number	:	602-492-7150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	04/20/2026

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