Organization
SELF
Active
Organization
SELF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL RAIMONDI LPC 14499/LISAC 1158 (THERAPIST)
(602) 569-4328
Entity
Organization
Contact information
Practice address
5010 E SHEA BLVD STE D202, SCOTTSDALE, AZ 85254-4570
(602) 569-4328
(602) 569-4378
Mailing address
5010 E SHEA BLVD STE D202, SCOTTSDALE, AZ 85254-4570
(602) 569-4328
(602) 569-4378
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC 14499
AZ
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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