Individual
DR. LAWRENCE MARK SIDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10269 N CENTRAL AVE, PHOENIX, AZ 85020-1051
(602) 677-1206
Mailing address
10269 N CENTRAL AVE, PHOENIX, AZ 85020-1051
(602) 677-1206
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10540
AZ
101YP2500X
Professional Counselor
11790
AZ
103TC0700X
Clinical Psychologist
3015
AZ
Other
Enumeration date
03/22/2007
Last updated
09/11/2025
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