Provider Demographics
NPI:1124668280
Name:MORITZ-SARRETT, MICHELE LEE (MPC, LASAC, BHP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEE
Last Name:MORITZ-SARRETT
Suffix:
Gender:F
Credentials:MPC, LASAC, BHP
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:L
Other - Last Name:SARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPC, LASAC, BHP
Mailing Address - Street 1:29525 N 144TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-7838
Mailing Address - Country:US
Mailing Address - Phone:480-341-0684
Mailing Address - Fax:
Practice Address - Street 1:1655 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8169
Practice Address - Country:US
Practice Address - Phone:480-969-6955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLASAC-15092101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor