Provider Demographics
NPI:1447235221
Name:FICELI, JUDITH ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:FICELI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E MISSOURI AVE
Mailing Address - Street 2:STE 390
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2752
Mailing Address - Country:US
Mailing Address - Phone:602-843-0000
Mailing Address - Fax:602-997-1305
Practice Address - Street 1:1110 E MISSOURI AVE
Practice Address - Street 2:STE 390
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2752
Practice Address - Country:US
Practice Address - Phone:602-843-0000
Practice Address - Fax:602-997-1305
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW10731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical