Provider Demographics
NPI:1033268560
Name:PIETREWICZ, DONNA ALEXIS (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:ALEXIS
Last Name:PIETREWICZ
Suffix:
Gender:F
Credentials:MSW, LCSW
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1400 E. SOUTHERN AVE
Mailing Address - Street 2:STE. 735
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5998
Mailing Address - Country:US
Mailing Address - Phone:480-804-0326
Mailing Address - Fax:480-887-9685
Practice Address - Street 1:10799 N 90TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6110
Practice Address - Country:US
Practice Address - Phone:480-804-0326
Practice Address - Fax:480-804-0083
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-117731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ248422Medicaid