Provider Demographics
NPI:1568550796
Name:ZAMUDIO, RAYMOND (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:ZAMUDIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 N 3RD ST
Mailing Address - Street 2:SUITE 2008
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1129
Mailing Address - Country:US
Mailing Address - Phone:602-264-4600
Mailing Address - Fax:602-264-7325
Practice Address - Street 1:2700 N 3RD ST
Practice Address - Street 2:SUITE 2008
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1129
Practice Address - Country:US
Practice Address - Phone:602-264-4600
Practice Address - Fax:602-264-7325
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1041C0700X
CT1041C0700X
AZ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical