Provider Demographics
NPI:1689356032
Name:CHAVEZ, TEENA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:TEENA
Middle Name:MARIE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11542 W SCOTTS DR
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-3900
Mailing Address - Country:US
Mailing Address - Phone:623-698-2433
Mailing Address - Fax:
Practice Address - Street 1:9520 W PALM LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4403
Practice Address - Country:US
Practice Address - Phone:623-289-1654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-216521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical