Active NPI
Michelle R Fontaine-Ybarra, LMSW
- Clinical Social Worker
- Gilbert, AZ
National Provider Identifier
1346426186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LMSW-11659
- Practice address
- 992 N Kirby St
Gilbert, AZ 85234-2209 - Phone
- (480) 832-2150
- NPI assigned
- Jan 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LMSW-11659 | AZ | Primary |
Addresses
Primary practice location
992 N Kirby St
Gilbert, AZ 85234-2209
Mailing address
992 N Kirby St
Gilbert, AZ 85234-2209
Phone (480) 832-2150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-11659 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199923200000",
"number": "1346426186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "992 N KIRBY ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342209",
"telephone_number": "480-832-2150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "992 N KIRBY ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342209",
"telephone_number": "480-832-2150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTAINE-YBARRA",
"first_name": "MICHELLE",
"middle_name": "R",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-10",
"last_updated": "2008-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LMSW-11659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.