Individual provider Active NPI

Luci Belcher

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1396093464
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
72976 Issued in CA
Practice address
4406 E Gatewood Rd
Phoenix, AZ 85050-6937
Phone
(480) 382-0322
NPI assigned
Aug 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 20137 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 72976 CA Primary

Addresses

Primary practice location

4406 E Gatewood Rd
Phoenix, AZ 85050-6937

Mailing address

10717 Camino Ruiz
Suite 207
San Diego, CA 92126-2360

Other practice location 1

10717 Camino Ruiz
Suite 207
San Diego, CA 92126-2360
Phone (858) 695-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241223003395 CA Practitioner - Clinical Social Worker 2062949415 Reassigns benefits to 1 organization
I20241230002774 AZ Practitioner - Clinical Social Worker 2062949415 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20137AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Nov 22, 2024 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Nov 27, 2024 Accepting new patients
Glenn Medical Center, LLC PastSince Oct 19, 2024 Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Clinical Past Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1396093464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 CAMINO RUIZ",
            "address_2": "SUITE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406 E GATEWOOD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850506937",
            "telephone_number": "480-382-0322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10717 Camino Ruiz",
            "address_2": "Suite 207",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921262360",
            "country_code": "US",
            "telephone_number": "858-695-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELCHER",
        "first_name": "LUCI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "20137",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "72976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.