Provider Demographics
NPI:1154519585
Name:LENZO, GARY (MSW/LMSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:LENZO
Suffix:
Gender:M
Credentials:MSW/LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E BROADWAY RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1525
Mailing Address - Country:US
Mailing Address - Phone:480-929-5100
Mailing Address - Fax:480-731-1066
Practice Address - Street 1:1225 E BROADWAY RD
Practice Address - Street 2:SUITE 240
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1525
Practice Address - Country:US
Practice Address - Phone:480-929-5100
Practice Address - Fax:480-731-1066
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-12095104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker