Active NPI
Judy Enos, LCSW
- Clinical Social Worker
- Laveen, AZ
National Provider Identifier
1053391474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10818
- Practice address
- 12705 S 67TH Ave
Laveen, AZ 85339-7925 - Phone
- (928) 221-7873
- NPI assigned
- Jan 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10818 | AZ | Primary |
Addresses
Primary practice location
12705 S 67TH Ave
Laveen, AZ 85339-7925
Mailing address
12705 S 67TH Ave
Laveen, AZ 85339-7925
Phone (928) 221-7873
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10818 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1053391474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12705 S 67TH AVE",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "853397925",
"telephone_number": "928-221-7873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12705 S 67TH AVE",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "853397925",
"telephone_number": "928-221-7873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENOS",
"first_name": "JUDY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-20",
"last_updated": "2021-01-28",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "10818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laveen, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.