Provider Demographics
NPI:1962515163
Name:PINEDA, ESTHER (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:
Last Name:PINEDA
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 1:8807 S DEAN RD
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-3251
Mailing Address - Country:US
Mailing Address - Phone:602-577-4424
Mailing Address - Fax:623-691-6655
Practice Address - Street 1:6006 N 83RD AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85303-4119
Practice Address - Country:US
Practice Address - Phone:623-772-5167
Practice Address - Fax:623-218-1859
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-11093101YS0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ880006Medicaid
880006Medicare UPIN
AZPTAN 117635Medicare UPIN