Individual provider Active NPI

Mary Elizabeth Huckaby, LCSW

  • Clinical Social Worker
  • Scottsdale, AZ
National Provider Identifier
1437393071
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2006022758 Issued in MO
Practice address
8160 E Butherus Dr Ste 5
Scottsdale, AZ 85260-2523
Phone
(816) 694-4030
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2006022758 MO
Clinical Social Worker 1041C0700X 2006022758 MO Primary

Addresses

Primary practice location

8160 E Butherus Dr Ste 5
Scottsdale, AZ 85260-2523

Mailing address

7611 State Line Rd
Suite 226
Kansas City, MO 64114-6801
Phone (816) 753-7071

Other practice location 1

7611 State Line Rd
Suite 226
Kansas City, MO 64114-6801
Phone (816) 753-7071

Other practice location 2

300 SE 2nd St Ste 100
Lees Summit, MO 64063-2759
Phone (816) 404-6170

Other identifiers 1

IdentifierTypeStateIssuer
499381705MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20090831000203 MO Practitioner - Clinical Social Worker 0143375915 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006022758MOMDClinical Social Worker
22568AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Wounds LLC CurrentSince Dec 4, 2024 Accepting new patients
Truman Medical Center Incorporated Past Accepting new patients
Truman Medical Center, Incorporated Past Accepting new patients

Locations

8160 E Butherus Dr
Ste 5
Scottsdale, AZ 85260
Phone (210) 355-6207

Organizations & group practices 4

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": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1437393071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 STATE LINE RD",
            "address_2": "SUITE 226",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641146801",
            "telephone_number": "816-753-7071",
            "fax_number": "816-926-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 E BUTHERUS DR STE 5",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602523",
            "telephone_number": "816-694-4030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7611 State Line Rd",
            "address_2": "Suite 226",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641146801",
            "country_code": "US",
            "telephone_number": "816-753-7071",
            "fax_number": "816-926-9180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 SE 2nd St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640632759",
            "country_code": "US",
            "telephone_number": "816-404-6170",
            "fax_number": "816-525-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKABY",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2006022758",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2006022758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499381705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.