Provider Demographics
NPI:1851577944
Name:BAHADAR, MANDEE SUE ROWLEY (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:MANDEE
Middle Name:SUE ROWLEY
Last Name:BAHADAR
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 W GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7672
Mailing Address - Country:US
Mailing Address - Phone:602-279-0008
Mailing Address - Fax:602-279-2004
Practice Address - Street 1:7560 S WILLOW DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5004
Practice Address - Country:US
Practice Address - Phone:480-584-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-11737101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health