Provider Demographics
NPI:1477797504
Name:GELDMACHER, LEE E (LMFT)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:E
Last Name:GELDMACHER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5228 SCENIC CREST WAY
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301
Mailing Address - Country:US
Mailing Address - Phone:702-335-2306
Mailing Address - Fax:702-947-7224
Practice Address - Street 1:510 E. MOELLER ST.
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301
Practice Address - Country:US
Practice Address - Phone:702-335-2306
Practice Address - Fax:702-947-7224
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVM10126106H00000X
AZLMFT15206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist