Vivian Fajardo, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW-18599 Issued in AZ

Practice address

7865 W Bell Rd # 1056
Peoria, AZ 85382-3803

Phone

(602) 825-3925

NPI assigned

Jun 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Alzheimers InstituteGroup PAC ID 8527070101, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Banner Alzheimer'S Institute

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1013966712

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  AZ

  Medicare reassignment NPD
• Banner Alzheimer'S Institute

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1730651738
  NPD
• Banner Sun City Medical Group

  • Multi-Specialty Clinic/Center
  • Sun City, AZ
  • NPI 1902067200
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1407471543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7865 W BELL RD # 1056",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823803",
            "telephone_number": "602-825-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7865 W BELL RD # 1056",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823803",
            "telephone_number": "602-825-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "VIVIAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LCSW-18599",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-18599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082142",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preston Eyerman, PMHNP-BC
• Eyes Ears & Vitality LLC
• Madison Fagerlie
• Shawn Fairchild
• Malvina Faja, PHARMD
• Charles Edward Falk, D.D.S.
• Family First Nemt LLC
• Family Partners
• Family Support Care LLC
• Grant T Fankhauser, M.D.

• Social Worker in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.