Individual provider Active NPI

Anita B Hicks, M.S.

  • Clinical Social Worker
  • Scottsdale, AZ
National Provider Identifier
1235123548
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW1930 Issued in AZ
Practice address
4300 N Miller Rd
Ste. 102
Scottsdale, AZ 85251-3619
Phone
(489) 994-9868
Fax
(602) 956-9711
NPI assigned
Sep 1, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW1930 AZ Primary
Clinical Social Worker 1041C0700X IL

Addresses

Primary practice location

4300 N Miller Rd
Ste. 102
Scottsdale, AZ 85251-3619

Mailing address

4950 E Rockridge Rd
Phoenix, AZ 85018-1827
Phone (602) 956-9711

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LCSW1930AZMDClinical Social Worker
149003627ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235123548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 E ROCKRIDGE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850181827",
            "telephone_number": "602-956-9711",
            "fax_number": "602-956-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 N MILLER RD",
            "address_2": "STE. 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513619",
            "telephone_number": "489-994-9868",
            "fax_number": "602-956-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ANITA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW1930",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.