Provider Demographics
NPI:1740163948
Name:TEJAL MISRA
Entity type:Organization
Organization Name:TEJAL MISRA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MISRA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:267-225-3549
Mailing Address - Street 1:9393 N 90TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5073
Mailing Address - Country:US
Mailing Address - Phone:267-225-3549
Mailing Address - Fax:
Practice Address - Street 1:9393 N 90TH ST, SUITE 102 #567
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:267-225-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty