Provider Demographics
NPI:1245544071
Name:LEIMSIEDER, MURRAY ELLIS (MA, LAC & CRC)
Entity type:Individual
Prefix:MR
First Name:MURRAY
Middle Name:ELLIS
Last Name:LEIMSIEDER
Suffix:
Gender:M
Credentials:MA, LAC & CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 S OCOTILLO AVE
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85602-6405
Mailing Address - Country:US
Mailing Address - Phone:520-586-7080
Mailing Address - Fax:520-586-6104
Practice Address - Street 1:590 S OCOTILLO AVE
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:AZ
Practice Address - Zip Code:85602-6405
Practice Address - Country:US
Practice Address - Phone:520-586-7080
Practice Address - Fax:520-586-6104
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12472101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health