Provider Demographics
NPI:1790951002
Name:FIMBRES, MARY HELEN (MSW MHR LCSW ACSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:HELEN
Last Name:FIMBRES
Suffix:
Gender:F
Credentials:MSW MHR LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 W NORTHERN
Mailing Address - Street 2:#117 NORTHERN EXECUTIVE PLAZA
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301
Mailing Address - Country:US
Mailing Address - Phone:623-937-3556
Mailing Address - Fax:623-937-3557
Practice Address - Street 1:5400 W NORTHERN
Practice Address - Street 2:#117 NORTHERN EXECUTIVE PLAZA
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301
Practice Address - Country:US
Practice Address - Phone:623-937-3556
Practice Address - Fax:623-937-3557
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW0551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health