Debra Logan LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10464 Issued in AZ

Legal business name

DEBRA LOGAN LCSW LLC

Practice address

101 S Main St Ste D
Cottonwood, AZ 86326-6979

Phone

(928) 202-9054

NPI assigned

Mar 2, 2017

Last updated

Jul 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra LoganNPI 1134126816

Title

Provider

Phone

(928) 202-9054

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Debra Lee Logan, LCSW

  • Clinical Social Worker
  • Cheyenne, WY
  • NPI 1134126816

  AZ

  Medicare reassignment NPD Authorized official
• Darlene C Stiffler, LCSW

  • Clinical Social Worker
  • Ballston Spa, NY
  • NPI 1124107859
  NPD (past)

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1184164618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 W DESERT WILLOW DR",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863268304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST STE D",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266979",
            "telephone_number": "928-202-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA LOGAN LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-02",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "928-202-9054"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "10464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davis Medical Center PC
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• Dennis J. Reed, MD PC
• Peggy Denton, IBCLC
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• Alliejane Boaz Desoto
• Leslie Devine

• Clinical Social Worker in Cottonwood, AZ
• Providers in Cottonwood, 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 Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.