Provider Demographics
NPI:1609347988
Name:RANDI ROTWEIN-PIVNICK M.A., LMFT, INC
Entity Type:Organization
Organization Name:RANDI ROTWEIN-PIVNICK M.A., LMFT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTWEIN-PIVNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA , LMFT
Authorized Official - Phone:480-707-8291
Mailing Address - Street 1:3555 N PASEO DEL SOL
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-1897
Mailing Address - Country:US
Mailing Address - Phone:480-707-8291
Mailing Address - Fax:
Practice Address - Street 1:3303 E BASELINE RD STE 114
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2740
Practice Address - Country:US
Practice Address - Phone:480-707-8291
Practice Address - Fax:480-545-6773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health