Individual provider Active NPI

Marlena Beatrice Stanford, LMSW

  • Social Worker
  • Phoenix, AZ
National Provider Identifier
1124809629
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
22564 Issued in AZ
Practice address
16601 N 40TH St Ste 216
Phoenix, AZ 85032-3354
Phone
(480) 788-8466
NPI assigned
Oct 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 22564 AZ Primary

Addresses

Primary practice location

16601 N 40TH St Ste 216
Phoenix, AZ 85032-3354

Mailing address

16601 N 40TH St Ste 216
Phoenix, AZ 85032-3354
Phone (970) 901-8575

Other practice location 1

3707 E Southern Ave
Mesa, AZ 85206-2569
Phone (480) 485-7222

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22564AZMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1124809629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 216",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323354",
            "telephone_number": "970-901-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 216",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323354",
            "telephone_number": "480-788-8466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3707 E Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852062569",
            "country_code": "US",
            "telephone_number": "480-485-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "MARLENA",
        "middle_name": "BEATRICE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-10",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "22564",
            "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 Jan 21, 2025; 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.