MEDICARE: MARIE THERESE WEBB MSW

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	101YM0800X	Mental Health Counselor	LCSW1551	AZ

General Provider Information

NPI Number	:	1609973262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE THERESE WEBB MSW

Provider Business Mailing Address
First Line	:	5070 N 40TH ST
Second Line	:	SUITE 200
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2148
Country	:	US
Telephone Number	:	602-954-6700
Fax Number	:	602-954-0190

Provider Business Practice Location Address
First Line	:	5070 N 40TH ST
Second Line	:	SUITE 200
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2148
Country	:	US
Telephone Number	:	602-954-6700
Fax Number	:	602-954-0190

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

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	07/08/2007

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