Provider Demographics
NPI:1932675717
Name:TAFARO, WILLIAM DAVID (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DAVID
Last Name:TAFARO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W RAWHIDE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-6416
Mailing Address - Country:US
Mailing Address - Phone:480-740-8175
Mailing Address - Fax:
Practice Address - Street 1:2509 S POWER RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-6695
Practice Address - Country:US
Practice Address - Phone:480-912-4691
Practice Address - Fax:480-912-7317
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-17949101YM0800X
AZLAC-15799101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health