Active NPI
Kellie Farrell, LMSW
- Social Worker
- Glendale, AZ
National Provider Identifier
1235721184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-18218
- Practice address
- 17505 N 79TH Ave Ste 410
Glendale, AZ 85308-8732 - Phone
- (623) 800-7980
- NPI assigned
- Feb 10, 2021
- Last updated
- Feb 10, 2021
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-18218 | AZ | Primary |
Addresses
Primary practice location
17505 N 79TH Ave Ste 410
Glendale, AZ 85308-8732
Mailing address
39625 N 1St PL
Phoenix, AZ 85086-7512
Phone (520) 465-2343
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 |
|---|---|---|---|
| LMSW-18218 | AZ | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surge Points LLC | Social Worker | Current | Accepting new patients |
Locations
17505 N 79th Ave
Ste 410
Glendale, AZ 85308
Phone (623) 800-7945
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1235721184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39625 N 1ST PL",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850867512",
"telephone_number": "520-465-2343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17505 N 79TH AVE STE 410",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088732",
"telephone_number": "623-800-7980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "KELLIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-10",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "LMSW-18218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.