Provider Demographics
NPI:1386269678
Name:LEVERIZA, ANNA MARIE VARGAS (PHD, LPC, LASAC)
Entity type:Individual
Prefix:
First Name:ANNA MARIE
Middle Name:VARGAS
Last Name:LEVERIZA
Suffix:
Gender:
Credentials:PHD, LPC, LASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18640 W KENDALL ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-7478
Mailing Address - Country:US
Mailing Address - Phone:602-315-9529
Mailing Address - Fax:
Practice Address - Street 1:18640 W KENDALL ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-7478
Practice Address - Country:US
Practice Address - Phone:602-315-9529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-18323101YP2500X
AZ21451101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional