Active NPI
Beth Ann Elliott, LCSW
- Clinical Social Worker
- Phoenix, AZ
National Provider Identifier
1194074930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149016637
- Practice address
- 650 E Indian School Rd
BLDG 23a Hud-Vash
Phoenix, AZ 85012-1839 - Phone
- (602) 222-6550
- NPI assigned
- Sep 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149016637 | IL | Primary |
Addresses
Primary practice location
650 E Indian School Rd
BLDG 23a Hud-Vash
Phoenix, AZ 85012-1839
Mailing address
44 W Monroe St
Apt 903
Phoenix, AZ 85003-4553
Phone (602) 800-4139
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149016637 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404000000000",
"number": "1194074930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 W MONROE ST",
"address_2": "APT 903",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850034553",
"telephone_number": "602-800-4139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E INDIAN SCHOOL RD",
"address_2": "BLDG 23A HUD-VASH",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850121839",
"telephone_number": "602-222-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "BETH ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-07",
"last_updated": "2014-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149016637",
"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 Jun 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.