Provider Demographics
NPI:1790583433
Name:OJEDA, IMELDA (LMSW)
Entity type:Individual
Prefix:
First Name:IMELDA
Middle Name:
Last Name:OJEDA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8627 N 51ST DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4903
Mailing Address - Country:US
Mailing Address - Phone:602-405-3407
Mailing Address - Fax:
Practice Address - Street 1:4500 S LAKESHORE DR STE 415
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7056
Practice Address - Country:US
Practice Address - Phone:480-234-9256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW22652104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker