Emily Katherine Abt, LCSW

Key facts

NPI

1366050650

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

LCSW-20201 (AZ)

Practice address

300 W Clarendon Ave Ste 140
Phoenix, AZ 85013-3449

Phone

(602) 675-6340

NPI assigned

Jul 22, 2020

Sex

Female

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

Specialties & licenses

Addresses

Other names

• Emily Katherine Roward Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 12, 2022.

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1366050650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133449",
            "telephone_number": "602-675-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133449",
            "telephone_number": "602-675-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABT",
        "first_name": "EMILY",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-20201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ROWARD",
            "middle_name": "KATHERINE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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