Provider Demographics
NPI:1588035877
Name:WAITE, CLAUDETTE (LPC)
Entity Type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:
Last Name:WAITE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16815 S DESERT FOOTHILLS PKWY STE 134
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-8465
Mailing Address - Country:US
Mailing Address - Phone:602-550-5221
Mailing Address - Fax:602-419-2996
Practice Address - Street 1:16815 S DESERT FOOTHILLS PKWY STE 134
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-8465
Practice Address - Country:US
Practice Address - Phone:602-550-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15820101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health