Individual provider Active NPI

Bonnie Hartley, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1013346766
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW1295 Issued in AZ
Practice address
3141 N 3Rd Ave
Phoenix, AZ 85013-4360
Phone
(602) 914-1520
Fax
(602) 914-1521
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW1295 AZ Primary

Addresses

Primary practice location

3141 N 3Rd Ave
Phoenix, AZ 85013-4360

Mailing address

5002 S Birch St
Tempe, AZ 85282-7211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW1295AZMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1013346766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 S BIRCH ST",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 N 3RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134360",
            "telephone_number": "602-914-1520",
            "fax_number": "602-914-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "BONNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW1295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.