Provider Demographics
NPI:1194951053
Name:PATEL, PINAL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PINAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22633 E INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-2116
Mailing Address - Country:US
Mailing Address - Phone:847-769-3944
Mailing Address - Fax:847-789-0085
Practice Address - Street 1:22633 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-2116
Practice Address - Country:US
Practice Address - Phone:847-769-3944
Practice Address - Fax:847-789-0085
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490136391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical