Provider Demographics
NPI:1639250244
Name:NEVITT, HAL MURRAY (LCSW LISAC CEAP)
Entity Type:Individual
Prefix:MR
First Name:HAL
Middle Name:MURRAY
Last Name:NEVITT
Suffix:
Gender:M
Credentials:LCSW LISAC CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13835 N TATUM BLVD # 9-178
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5581
Mailing Address - Country:US
Mailing Address - Phone:602-885-4533
Mailing Address - Fax:
Practice Address - Street 1:3241 E. SHEA BLVD #9
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028
Practice Address - Country:US
Practice Address - Phone:602-885-4533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-0837101YA0400X
AZLCSW-34061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical