Fajardo, Vivian

Fajardo, Vivian is an sole proprietor health care provider with primary practice located at 7865 W Bell Rd # 1056 , Peoria AZ 85382-3803. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Fajardo, Vivian can be contacted via phone (602) 825-3925.

Contact Information

Primary practice address
7865 W Bell Rd # 1056 Peoria AZ 85382-3803
Phone: (602) 825-3925
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X LCSW-18599 Arizona
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-18599 Arizona

Profile Details

NPI number 1407471543
LBN Legal business name Fajardo, Vivian
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 15th, 2020
Last updated Sep 30th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407471543 NPPES
Arizona MEDICAID 082142

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