Individual provider Active NPI

Stephanie Hackett, LMSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1255077152
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-22215 Issued in AZ
Practice address
3330 N 2ND St Ste 601
Phoenix, AZ 85012-2395
Phone
(602) 230-7373
Fax
(602) 230-5105
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-17747 AZ
Clinical Social Worker 1041C0700X LCSW-22215 AZ Primary

Addresses

Primary practice location

3330 N 2ND St Ste 601
Phoenix, AZ 85012-2395

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

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
I20240710004628 AZ Practitioner - Clinical Social Worker 6901341288 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-17747AZMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince Jun 1, 2024 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC CurrentSince Jun 1, 2024 Accepting new patients
Denova Collaborative Health, LLC Past Accepting new patients

Locations

2120 W Guadalupe Rd
Ste 6
Mesa, AZ 85202
Phone (480) 629-8577

3330 N 2nd St
Ste 601
Phoenix, AZ 85012
Phone (602) 234-3444

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

3620 N 3rd St
Phoenix, AZ 85012
Phone (602) 329-8250

77 E Columbus Ave
Ste 210
Phoenix, AZ 85012

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1255077152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 N 2ND ST STE 601",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122395",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "STEPHANIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-17747",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.