Active NPI
Lori Lynn Haas, MSW, LCSW, CEDS
- Clinical Social Worker
- Phoenix, AZ
National Provider Identifier
1417168287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW-3460
- Practice address
- 4025 E. Chandler Boulevard
#70-E7
Phoenix, AZ 85048 - Phone
- (602) 332-4360
- Fax
- (480) 831-9274
- NPI assigned
- May 24, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW-3460 | AZ | Primary |
Addresses
Primary practice location
4025 E. Chandler Boulevard
#70-E7
Phoenix, AZ 85048
Mailing address
4025 E. Chandler Boulevard
#70-E7
Phoenix, AZ 85048
Phone (602) 332-4360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 11, 2023 through Jan 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW-3460 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417168287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 E. CHANDLER BOULEVARD",
"address_2": "#70-E7",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85048",
"telephone_number": "602-332-4360",
"fax_number": "480-831-9274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 E. CHANDLER BOULEVARD",
"address_2": "#70-E7",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85048",
"telephone_number": "602-332-4360",
"fax_number": "480-831-9274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAS",
"first_name": "LORI",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "MSW, LCSW, CEDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "SW-3460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.