Provider Demographics
NPI:1710347042
Name:ARIZONA FAMILY INSTITUTE
Entity Type:Organization
Organization Name:ARIZONA FAMILY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-258-0338
Mailing Address - Street 1:1425 S LINDSAY RD
Mailing Address - Street 2:UNIT 36
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-6230
Mailing Address - Country:US
Mailing Address - Phone:317-258-0338
Mailing Address - Fax:
Practice Address - Street 1:3048 E BASELINE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7286
Practice Address - Country:US
Practice Address - Phone:317-258-0338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ137031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty