Individual provider Active NPI

Chel'Sea Ryan, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1093194532
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17120 Issued in AZ
Practice address
1101 N Central Ave
Phoenix, AZ 85004-1808
Phone
(602) 595-8145
NPI assigned
May 28, 2015
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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 17120 AZ Primary

Addresses

Primary practice location

1101 N Central Ave
Phoenix, AZ 85004-1808

Mailing address

1110 W Monterey St
Chandler, AZ 85224-3562
Phone (804) 305-0730

Other identifiers 1

IdentifierTypeStateIssuer
1093194532MedicaidAZ

Other names 1

  • Mrs. Chel'Sea Ryan - Watford Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cryan@integrohs.com

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
I20200128002080 AZ Practitioner - Clinical Social Worker 4082040795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Community CareGroup PAC ID 3678518016, 12 clinicians

Practice addresses (Care Compare)

1101 N Central Ave
Suite 200
Phoenix, AZ 85004-1844
Phone (602) 307-5330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17120AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Community Care Clinical CurrentSince Jan 13, 2020 Accepting new patients
Teris Health Services LLC Current Accepting new patients
Healing in Hues Current Accepting new patients
Teri's Health Services CurrentSince Aug 22, 2024 Accepting new patients

Locations

1101 N Central Ave
Ste 200
Phoenix, AZ 85004
Phone (602) 307-5330

14040 N Cave Creek Rd
Ste 205
Phoenix, AZ 85022
Phone (602) 358-7073

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAFJCA

Organizations & group practices 4

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": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1093194532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W MONTEREY ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243562",
            "telephone_number": "804-305-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041808",
            "telephone_number": "602-595-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CHEL'SEA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "17120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093194532",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cryan@integrohs.com",
            "affiliation": "N",
            "address_1": "1501 E Orangewood Ave",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850205130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHEL'SEA",
            "last_name": "RYAN - WATFORD",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.