Odessa Mavis Thomas Hancock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-22353 Issued in AZ

Practice address

13395 N Marana Main St BLDG B
Marana, AZ 85653-7008

Phone

(520) 682-1091

NPI assigned

Sep 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: odessa.hancock.1@32652.direct.athenahealth.com

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.

• Marana Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Marana, AZ
  • NPI 1447263405

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Marana Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1396512034
  NPD
• Marana Health Center, Inc

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)
• Green Light Counseling, Inc.

  • Professional Counselor
  • Greensboro, NC
  • NPI 1619287190
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1376826719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13395 N MARANA MAIN ST BLDG B",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856537008",
            "telephone_number": "520-682-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13395 N MARANA MAIN ST BLDG B",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856537008",
            "telephone_number": "520-682-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "ODESSA",
        "middle_name": "MAVIS THOMAS",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "P005543",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "P015881",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-19637",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NC",
            "license": "1217085",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22353",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-15573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Gulli Barbier, LISAC
• Victoria Guzman-Grass
• Andrea Hale
• Sandra Hambacher, SLP
• Elissa Hambright
• Amy Elizabeth Harding, NMD
• Rebecca Ione Hartzell, PHD, BCBA-D
• Nassau D Harvey
• Julia Hennagir, D.C.
• Jean Elaine Henriksen, P.T.

• Clinical Social Worker in Marana, AZ
• Providers in Marana, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.