Individual provider Active NPI

Joe Anthony Santos, ACSW,LCSW,DCSW,BCD

  • Clinical Social Worker
  • Sierra Vista, AZ
National Provider Identifier
1306076732
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 20331 Issued in AZ
Practice address
77 Calle Portal Ste C240
Sierra Vista, AZ 85635-2986
Phone
(520) 452-1436
Fax
(520) 452-1447
NPI assigned
Jul 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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 01103 TX
Clinical Social Worker 1041C0700X SW 20331 AZ Primary

Addresses

Primary practice location

77 Calle Portal Ste C240
Sierra Vista, AZ 85635-2986

Mailing address

1450 Sunflower Way
Sierra Vista, AZ 85635-5530
Phone (520) 452-1436

Other identifiers 1

IdentifierTypeStateIssuer
751843MedicaidAZ

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
I20110621000225 AZ Practitioner - Clinical Social Worker 5092993147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1450 Sunflower Way
Sierra Vista, AZ 85635-5530

302 El Camino Real
BLDG 11 Suite a
Sierra Vista, AZ 85635-2860
Phone (520) 456-5885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 20331AZMDClinical Social Worker
01103TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Joe a. Santos, Acsw, LCSW, PLLC Clinical CurrentSince Jul 1, 2016 Accepting new patients
Arizona Counseling & Treatment Services, L.L.C. Past Accepting new patients

Locations

77 Calle Portal
Ste C240
Sierra Vista, AZ 85635
Phone (520) 335-6271

302 El Camino Real
Ste 11A
Sierra Vista, AZ 85635
Phone (520) 255-5475

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1306076732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 SUNFLOWER WAY",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856355530",
            "telephone_number": "520-452-1436",
            "fax_number": "520-452-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CALLE PORTAL STE C240",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352986",
            "telephone_number": "520-452-1436",
            "fax_number": "520-452-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "JOE",
        "middle_name": "ANTHONY",
        "credential": "ACSW,LCSW,DCSW,BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "01103",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "SW 20331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "751843",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.