Provider Demographics
NPI:1134823511
Name:MENDEZ, ELIZABETH (LSAT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:LSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2283
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85214-2283
Mailing Address - Country:US
Mailing Address - Phone:480-338-9158
Mailing Address - Fax:
Practice Address - Street 1:617 N SCOTTSDALE RD STE D
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4207
Practice Address - Country:US
Practice Address - Phone:480-990-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLSAT-15175101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)