Provider Demographics
NPI:1699901942
Name:HONIG, LARRY MARK (PHD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:MARK
Last Name:HONIG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 S CASITAS DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-4225
Mailing Address - Country:US
Mailing Address - Phone:520-247-3622
Mailing Address - Fax:520-247-3622
Practice Address - Street 1:927 S CASITAS DR
Practice Address - Street 2:UNIT B
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-4225
Practice Address - Country:US
Practice Address - Phone:520-247-3622
Practice Address - Fax:520-247-3622
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4032103TC0700X
AZPSY-4032103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical