Individual provider Active NPI

Gary Santorella, LCSW

  • Clinical Social Worker
  • Fountain Hills, AZ
National Provider Identifier
1396359378
Registry record updated Sep 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17326 Issued in CA
Practice address
16102 E Glenpoint Dr
Fountain Hills, AZ 85268-3115
Phone
(925) 518-6766
NPI assigned
Sep 7, 2020
Last updated
Sep 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17326 CA Primary

Addresses

Primary practice location

16102 E Glenpoint Dr
Fountain Hills, AZ 85268-3115

Mailing address

16102 E Glenpoint Dr
Fountain Hills, AZ 85268-3115
Phone (925) 518-6766

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

NPI Registry JSON

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1396359378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16102 E GLENPOINT DR",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683115",
            "telephone_number": "925-518-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16102 E GLENPOINT DR",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683115",
            "telephone_number": "925-518-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTORELLA",
        "first_name": "GARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-07",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "17326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.