Individual provider Active NPI

Susan M. Daubenbis, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1295920692
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW2599 Issued in AZ
Practice address
2942 N 24TH St
Suite 114
Phoenix, AZ 85016-7844
Phone
(602) 550-8101
Fax
(602) 995-7290
NPI assigned
Sep 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW2599 AZ Primary

Addresses

Primary practice location

2942 N 24TH St
Suite 114
Phoenix, AZ 85016-7844

Mailing address

2101 W Palmaire Ave
Phoenix, AZ 85021-7742
Phone (602) 550-8101

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

LicenseStateTypeSpecialty
LCSW2599AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1189296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1295920692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W PALMAIRE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217742",
            "telephone_number": "602-550-8101",
            "fax_number": "602-995-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2942 N 24TH ST",
            "address_2": "SUITE 114",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167844",
            "telephone_number": "602-550-8101",
            "fax_number": "602-995-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUBENBIS",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-09",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW2599",
            "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 Dec 7, 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.