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NPI Code Detail

MEDICARE: MICHAEL ISRAEL

MEDICARE: MICHAEL ISRAEL
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
11041C0700XClinical Social WorkerLCSW-22551AZ

General Provider Information

NPI Number : 1609141191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ISRAEL
Provider Business Mailing Address
First Line : 6250 S 40TH ST
Second Line : 8027
City : PHOENIX
State : AZ
Zip : 85042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10201 S 51ST ST STE 130
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-5226
Country : US
Telephone Number : 602-525-5783
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2012
Last Update Date : 10/08/2024

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