Doctor Name: | MICHAEL AARON MEDLEY |
NPI Number: | 1275851388 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSC/MFT LPC |
License Number: | LPC-13907 |
Business Practice Address: | 3048 E Baseline Rd Suite 108 Mesa, AZ - 852047286 |
Business Phone Number: | 4809624357 |
Business Fax Number: | 4803397182 |
Mailing Address: | 3048 E Baseline Rd, Suite 108 MESA |
State: | AZ |
Postal Code: | 852047286 |
Phone Number: | 4809624357 |
Fax Number: | 4803397182 |
NPI Enumeration Date: | 05/13/2010 |
NPI Last Update Date: | 09/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPC-13907 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |