Provider Demographics
NPI:1427153709
Name:KESSLER, ROGER (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:
Last Name:KESSLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7300 N DREAMY DRAW DR
Mailing Address - Street 2:UNIT # 104
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5243
Mailing Address - Country:US
Mailing Address - Phone:602-277-5551
Mailing Address - Fax:602-944-2410
Practice Address - Street 1:650 E INDIAN SCHOOL RD
Practice Address - Street 2:VAMC-PHOENIX, PTSD/PCT PROGRAM
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-8192
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:602-222-2723
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ#LCSW 11881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical