Individual provider Active NPI

Jennifer H Quinn, LCSW

  • Clinical Social Worker
  • Gilbert, AZ
National Provider Identifier
1043895816
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-22558 Issued in AZ
Practice address
855 S Cancun Dr # a
Gilbert, AZ 85233-7503
Phone
(602) 412-1551
Fax
(480) 571-8183
NPI assigned
Mar 13, 2021
Last updated
Nov 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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 LCSW-22558 AZ Primary

Addresses

Primary practice location

855 S Cancun Dr # a
Gilbert, AZ 85233-7503

Mailing address

855 S Cancun Dr
Gilbert, AZ 85233-7503
Phone (480) 685-0288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111003073 AZ Practitioner - Clinical Social Worker 4486188695 Reassigns benefits to 1 organization
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-22558AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways to Connection, LLC Clinical CurrentSince Sep 1, 2024 Accepting new patients
Blue Waters Therapy and Wellness LLC Clinical CurrentSince Nov 18, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1043895816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S CANCUN DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852337503",
            "telephone_number": "480-685-0288",
            "fax_number": "480-571-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S CANCUN DR # A",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852337503",
            "telephone_number": "602-412-1551",
            "fax_number": "480-571-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-13",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.