Dr Lawrence Mark Sideman, PHD is a
Psychologist - Clinical based in Phoenix, Arizona. Dr Lawrence Mark Sideman is licensed to practice in Arizona (license number 3015) and his current practice location is
10269 N Central Ave, Phoenix, Arizona. He can be reached at his office (for appointments etc.) via phone at
(602) 677-1206.
NPI number for Dr Lawrence Mark Sideman is 1275650749 and his current mailing address is 10269 N Central Ave, Phoenix, Arizona. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1275650749.
Healthcare Provider's Profile
| Full Name | Dr Lawrence Mark Sideman |
|---|
| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 10269 N Central Ave, Phoenix, Arizona |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1275650749
- Provider Enumeration Date: 03/22/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Lawrence Mark Sideman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275650749 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10540 (Arizona) | Primary |
| 101YP2500X | Counselor - Professional | 11790 (Arizona) | Primary |
| 103TC0700X | Psychologist - Clinical | 3015 (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lawrence Mark Sideman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Lawrence Mark Sideman, PHD
10269 N Central Ave,
Phoenix, AZ 85020-1051
Ph: (602) 677-1206 | Dr Lawrence Mark Sideman, PHD
10269 N Central Ave,
Phoenix, AZ 85020-1051
Ph: (602) 677-1206 |
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