Individual provider Active NPI

Breeanna Horton, LCSW

  • Clinical Social Worker
  • Peoria, AZ
National Provider Identifier
1306339395
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-19377 Issued in AZ
Practice address
8551 W Cherry Hills Dr
Peoria, AZ 85345-8172
Phone
(026) 425-0030
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-17029 AZ
Clinical Social Worker 1041C0700X LCSW-178583 AK
Clinical Social Worker 1041C0700X LCSW-19377 AZ Primary

Addresses

Primary practice location

8551 W Cherry Hills Dr
Peoria, AZ 85345-8172

Mailing address

8551 W Cherry Hills Dr
Peoria, AZ 85345-8172
Phone (602) 425-0030

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
I20220512001715 AZ Practitioner - Clinical Social Worker 3577967082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Love Lab PLLCGroup PAC ID 7113304114, 4 clinicians

Practice addresses (Care Compare)

8551 W Cherry Hills Dr
Peoria, AZ 85345-8172
Phone (602) 425-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-17029AZMDSocial Worker
LCSW-178583AKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Love Lab PLLC CurrentSince Apr 20, 2022 Accepting new patients

Locations

8160 W Union Hills Dr
Ste B202
Glendale, AZ 85308
Phone (602) 425-0030

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1306339395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8551 W CHERRY HILLS DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458172",
            "telephone_number": "602-425-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8551 W CHERRY HILLS DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458172",
            "telephone_number": "026-425-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "BREEANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2021-07-20",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-17029",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "LCSW-178583",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-19377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.