Provider Demographics
NPI:1588029318
Name:HUZEVKA, NATASHA (LCSW)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HUZEVKA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12725 W INDIAN SCHOOL RD STE E101
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-9525
Mailing Address - Country:US
Mailing Address - Phone:602-730-5366
Mailing Address - Fax:
Practice Address - Street 1:12725 W INDIAN SCHOOL RD STE E101
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-9525
Practice Address - Country:US
Practice Address - Phone:480-253-9665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-228781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ034682Medicare PIN