Provider Demographics
NPI:1639901846
Name:MAY, IYAMIDE (LMSW)
Entity type:Individual
Prefix:
First Name:IYAMIDE
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 N ARIZONA AVE UNIT 1336
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0715
Mailing Address - Country:US
Mailing Address - Phone:732-491-3038
Mailing Address - Fax:
Practice Address - Street 1:777 W SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-5008
Practice Address - Country:US
Practice Address - Phone:602-279-5262
Practice Address - Fax:480-264-5099
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-21949101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor