Jeffrey M Ainsa, LCSW
Individual provider Active NPI Clinical Social Worker · Surprise, AZ
NPI 1306131511 · NPPES record last updated Aug 21, 2018
Key facts
- NPI
- 1306131511
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW-17210 (AZ)
- Practice address
- 15331 W Bell Rd Ste 212
Surprise, AZ 85374 - Phone
- (602) 644-1198
- NPI assigned
- Jun 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-17210 | AZ | MD | Clinical Social Worker |
| LMSW-13186 | AZ | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LMSW-13186 | AZ | |
| Clinical Social Worker | 1041C0700X | LCSW-17210 | AZ | Yes |
Addresses
Primary practice location
15331 W Bell Rd Ste 212
Surprise, AZ 85374
Mailing address
15331 W Bell Rd Ste 212
Surprise, AZ 85374-4104
Phone (602) 644-1198
Other practice location 1
4414 N 19th Ave
Phoenix, AZ 85015-4114
Phone (602) 285-5550 ext. 318
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306131511 | Medicaid | AZ |
Other providers in Surprise, AZ
- Aguer Group Home
- Amy Aguilar Santana
- Pamela Bunnell Ahlmer
- Huda N Ahmed
- Ahwatukee Health Care, LLC
- Nader R. Ajluni
- Prisca Ajonghage
- Folake Akanbi
- Akobuwet Psychiatry PLLC
- Ahmed Al Ezzi
All providers in Surprise, AZ · Clinical Social Worker in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.