Provider Demographics
NPI:1366929374
Name:ISRAEL EL, ALFONSO (LPC)
Entity type:Individual
Prefix:
First Name:ALFONSO
Middle Name:
Last Name:ISRAEL EL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2874 S NIELSON ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-8300
Mailing Address - Country:US
Mailing Address - Phone:502-224-8180
Mailing Address - Fax:
Practice Address - Street 1:1760 E PECOS RD STE 344
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-3208
Practice Address - Country:US
Practice Address - Phone:480-907-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20598101YP2500X
AZ7213T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional