Individual provider Active NPI

Debra Lynn Stutz-Middleton, LCSW

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1396925384
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-12486 Issued in AZ
Practice address
9124 E Main St Ste 20-21
Mesa, AZ 85207-8700
Phone
(480) 295-8070
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4244 CO
Clinical Social Worker 1041C0700X 992201 CO
Clinical Social Worker 1041C0700X LCSW-12486 AZ Primary

Addresses

Primary practice location

9124 E Main St Ste 20-21
Mesa, AZ 85207-8700

Mailing address

9124 E Main St Ste 20-21
Mesa, AZ 85207-8700
Phone (480) 295-8070

Other names 1

  • Debra Lynn Stutz Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-12486AZMDClinical Social Worker
992201COMDClinical Social Worker
4244COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Iora Health, LLC Past Accepting new patients
Iora Health Massachusetts, P.C. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1396925384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9124 E MAIN ST STE 20-21",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852078700",
            "telephone_number": "480-295-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9124 E MAIN ST STE 20-21",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852078700",
            "telephone_number": "480-295-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZ-MIDDLETON",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "4244",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "992201",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "STUTZ",
            "middle_name": "LYNN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.