Provider Demographics
NPI:1922187368
Name:MARIETTI, ELIZABETH M (CSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:MARIETTI
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 E MORGAN TRL
Mailing Address - Street 2:#4
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1232
Mailing Address - Country:US
Mailing Address - Phone:480-607-7852
Mailing Address - Fax:480-607-7842
Practice Address - Street 1:8040 E MORGAN TRAIL #4
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1232
Practice Address - Country:US
Practice Address - Phone:480-607-7852
Practice Address - Fax:480-607-7842
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW19971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ60323Medicare PIN