Provider Demographics
NPI:1306552708
Name:ROPER, ALIVIA DINEEN (LCSW)
Entity type:Individual
Prefix:
First Name:ALIVIA
Middle Name:DINEEN
Last Name:ROPER
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 1:7126 E OSBORN RD UNIT 1013
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6323
Mailing Address - Country:US
Mailing Address - Phone:860-462-0722
Mailing Address - Fax:
Practice Address - Street 1:2111 E HIGHLAND AVE STE B-200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4741
Practice Address - Country:US
Practice Address - Phone:860-462-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX690161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical