Provider Demographics
NPI:1629288782
Name:HADDAD, WALID (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WALID
Middle Name:
Last Name:HADDAD
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 1:8851 N ORACLE RD
Mailing Address - Street 2:SUITE 89
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7447
Mailing Address - Country:US
Mailing Address - Phone:520-797-3292
Mailing Address - Fax:
Practice Address - Street 1:7493 N ORACLE RD
Practice Address - Street 2:SUITE 123
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6343
Practice Address - Country:US
Practice Address - Phone:520-797-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 108791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ014120OtherVALUEOPTIONS