Individual provider Active NPI

Skye Bass, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1306353198
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-16954 Issued in AZ
Practice address
4212 N 16TH St BLDG 5
Phoenix, AZ 85016-5319
Phone
(602) 263-1200
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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-16954 AZ Primary

Addresses

Primary practice location

4212 N 16TH St BLDG 5
Phoenix, AZ 85016-5319

Mailing address

4212 N 16TH St BLDG 5
Phoenix, AZ 85016-5319
Phone (602) 263-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180212000962 TX Practitioner - Clinical Social Worker 1456611573 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS IHS Phoenix Area 10 clinicians

Practice addresses (Care Compare)

515 Shoshone Cir
Elko, NV 89801-5072
Phone (775) 738-2252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-16954AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jan 21, 2018 Accepting new patients
PHS Indian Hospital CurrentSince Jun 1, 2024 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jan 21, 2018 Accepting new patients
DHHS IHS Phoenix Area Current Accepting new patients
DHHS IHS Phoenix Area CurrentSince Jan 7, 2021 Accepting new patients

Locations

4212 N 16th St
Bldg 5
Phoenix, AZ 85016
Phone (602) 263-1518

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

515 Shoshone Cir
Elko, NV 89801
Phone (775) 738-2252

Organizations & group practices 5

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": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1306353198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST BLDG 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST BLDG 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "SKYE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-16954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.