Provider Demographics
NPI:1023447851
Name:MARY M. BUHMAN THERAPY SERVICES PLLC
Entity type:Organization
Organization Name:MARY M. BUHMAN THERAPY SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:480-570-5830
Mailing Address - Street 1:1717 N 77TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-2253
Mailing Address - Country:US
Mailing Address - Phone:712-540-3063
Mailing Address - Fax:712-546-8929
Practice Address - Street 1:1717 N 77TH ST STE 4
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-2253
Practice Address - Country:US
Practice Address - Phone:712-540-3063
Practice Address - Fax:712-546-8929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ16805OtherSTATE OF ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS
IA600247029Medicaid