Active NPI
Jennifer L Spaude, LCSW
- Clinical Social Worker
- Chandler, AZ
National Provider Identifier
1366072399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-18357
- Practice address
- 1270 N Dobson Rd
Chandler, AZ 85224-8548 - Phone
- (602) 903-0796
- NPI assigned
- Jan 17, 2020
- 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 | LCSW-18357 | AZ | Primary |
Addresses
Primary practice location
1270 N Dobson Rd
Chandler, AZ 85224-8548
Mailing address
1270 N Dobson Rd
Chandler, AZ 85224-8548
Phone (602) 903-0796
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1366072399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 N DOBSON RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852248548",
"telephone_number": "602-903-0796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 N DOBSON RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852248548",
"telephone_number": "602-903-0796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPAUDE",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW-18357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.