Provider Demographics
NPI:1043635758
Name:AZ FAMILY THERAPY LLC
Entity Type:Organization
Organization Name:AZ FAMILY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEINWEBER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-327-5522
Mailing Address - Street 1:1661 N. SWAN RD
Mailing Address - Street 2:SUITE 244
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4053
Mailing Address - Country:US
Mailing Address - Phone:520-327-5522
Mailing Address - Fax:520-327-5525
Practice Address - Street 1:1661 N. SWAN RD
Practice Address - Street 2:SUITE 244
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4053
Practice Address - Country:US
Practice Address - Phone:520-327-5522
Practice Address - Fax:520-327-5525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW25951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty