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Individual

JEFFREY M AINSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
15331 W BELL RD STE 212, SURPRISE, AZ 85374
(602) 644-1198
Mailing address
15331 W BELL RD STE 212, SURPRISE, AZ 85374-4104
(602) 644-1198

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-17210
AZ
1041C0700X
Clinical Social Worker
LMSW-13186
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306131511
AZ
Enumeration date
06/15/2011
Last updated
08/21/2018
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