Marian C Eberly, RN, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-4127 Issued in AZ

Practice address

12612 N Black Canyon Hwy
Phoenix, AZ 85029-1345

Phone

(623) 252-7433

NPI assigned

Oct 13, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1164757902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12612 N BLACK CANYON HWY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291345",
            "telephone_number": "623-252-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12612 N BLACK CANYON HWY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291345",
            "telephone_number": "623-252-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLY",
        "first_name": "MARIAN",
        "middle_name": "C",
        "credential": "RN, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-4127",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN058888",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebenezer Behavioral Care, LLC
• Ebenezer House I , LLC
• Ebenezer House, LLC
• Fidelis Osondu Ebereonwu
• Renee S Eberhardt, LMT
• Lance Eberson, MD
• Jennifer Ebner, D.D.S.
• John A. Ebner, D.O.
• Ekaette Effiong Ebong, PHARM.D.
• Ebony House Inc

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.