Individual provider Active NPI

Eleanor Marilyn Gross, MSW

  • Clinical Social Worker
  • Scottsdale, AZ
National Provider Identifier
1144302209
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW3969 Issued in AZ
Practice address
10142 N 105TH Way
Scottsdale, AZ 85258-4924
Phone
(602) 622-1121
Fax
(480) 307-9660
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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 LCSW3969 AZ Primary

Addresses

Primary practice location

10142 N 105TH Way
Scottsdale, AZ 85258-4924

Mailing address

7647 Tarpon Cove Cir
Lake Worth, FL 33467-6930
Phone (480) 451-6563

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
I20180522000605 AZ Practitioner - Clinical Social Worker 5193745867 Practice locations: Scottsdale, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10142 N 105TH Way
Scottsdale, AZ 85258-4924
Phone (602) 622-1121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW3969AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1144302209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7647 TARPON COVE CIR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676930",
            "telephone_number": "480-451-6563",
            "fax_number": "480-451-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10142 N 105TH WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584924",
            "telephone_number": "602-622-1121",
            "fax_number": "480-307-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "ELEANOR",
        "middle_name": "MARILYN",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW3969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.