Provider Demographics
NPI:1164503470
Name:ROTWEIN, RANDI (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:
Last Name:ROTWEIN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:
Other - Last Name:ROTWEIN-PIVNICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:13120 N 102ND PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-7294
Mailing Address - Country:US
Mailing Address - Phone:480-707-8291
Mailing Address - Fax:480-944-8771
Practice Address - Street 1:13120 N 102ND PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7294
Practice Address - Country:US
Practice Address - Phone:480-707-8291
Practice Address - Fax:480-944-8771
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-10223106H00000X
CAMFC33469106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist