Provider Demographics
NPI:1760883466
Name:CREWS-SIPE, COLLEEN F (LISAC)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:F
Last Name:CREWS-SIPE
Suffix:
Gender:F
Credentials:LISAC
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:F
Other - Last Name:SIPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISAC
Mailing Address - Street 1:3003 N CENTRAL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2929
Mailing Address - Country:US
Mailing Address - Phone:602-685-6000
Mailing Address - Fax:602-302-7925
Practice Address - Street 1:262 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5932
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:602-389-3780
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-11430101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)