Individual provider Active NPI

Deborah Jeongweon Cheng, L.C.S.W.

  • Clinical Social Worker
  • Tempe, AZ
National Provider Identifier
1194967612
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW12393 Issued in AZ
Practice address
2120 S. McClintock Dr
Suite 105
Tempe, AZ 85282-4950
Phone
(480) 456-1169
NPI assigned
Mar 30, 2009
Last updated
Sep 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC11097 AZ
Clinical Social Worker 1041C0700X LCSW12393 AZ Primary

Addresses

Primary practice location

2120 S. McClintock Dr
Suite 105
Tempe, AZ 85282-4950

Mailing address

2120 S McClintock Dr Ste 105
Tempe, AZ 85282-2692
Phone (480) 456-1169

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
I20120524000618 AZ Practitioner - Clinical Social Worker 9931362159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

2120 S McClintock Dr
Suite 105
Tempe, AZ 85282-2692
Phone (480) 804-0326

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LISAC11097AZMDAddiction (Substance Use Disorder) Counselor
LCSW12393AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Crisis Preparation and Recovery, Inc CurrentSince Apr 7, 2012 Accepting new patients

Locations

10799 N 90th St
Ste 100
Scottsdale, AZ 85260
Phone (480) 804-0083

3260 N Hayden Rd
Ste 112
Scottsdale, AZ 85251
Phone (602) 264-9100

1400 E Southern Ave
Ste 735
Tempe, AZ 85282

2120 S McClintock Dr
Ste 105
Tempe, AZ 85282

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1194967612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 S MCCLINTOCK DR STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822692",
            "telephone_number": "480-456-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 S. MCCLINTOCK DR",
            "address_2": "SUITE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852824950",
            "telephone_number": "480-456-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "DEBORAH",
        "middle_name": "JEONGWEON",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC11097",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW12393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.