Individual provider Active NPI

Kathleen Ann Phalen, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1306286349
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-10934 Issued in AZ
Practice address
14632 N 2ND Dr
Phoenix, AZ 85023-5206
Phone
(602) 363-7441
NPI assigned
Jul 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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 LCSW-10934 AZ Primary

Addresses

Primary practice location

14632 N 2ND Dr
Phoenix, AZ 85023-5206

Mailing address

14632 N 2ND Dr
Phoenix, AZ 85023-5206
Phone (602) 363-7441

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
I20260618002997 AZ Practitioner - Clinical Social Worker 1456823657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14632 N 2ND Dr
Phoenix, AZ 85023-5206

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-10934AZMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1306286349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14632 N 2ND DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850235206",
            "telephone_number": "602-363-7441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14632 N 2ND DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850235206",
            "telephone_number": "602-363-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHALEN",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-10934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.