Provider Demographics
NPI:1710743703
Name:ARELLANO, ERICK (BSW)
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:ARELLANO
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12210 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5815
Mailing Address - Country:US
Mailing Address - Phone:307-922-6750
Mailing Address - Fax:
Practice Address - Street 1:3222 N 37TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-6304
Practice Address - Country:US
Practice Address - Phone:602-808-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker