Mary L Qualls, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW-13257 Issued in AZ

Practice address

501 E Plaza Cir Ste 13
Litchfield Park, AZ 85340-4909

Phone

(602) 818-2615

NPI assigned

Sep 8, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lucy Qualls Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 12, 2024 through Jul 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1467239087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 W AVALON DR",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853926645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E PLAZA CIR STE 13",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404909",
            "telephone_number": "602-818-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LCSW-13257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "QUALLS",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kristin Powers, PA-C
• Precision Wellness Center, LLC
• Brandy Preston, LAC
• Prosperous Recovery Homes LLC
• PT Cruizer LLC
• Marlyn L Quintana, RBT
• Crystal Marie Qureshi, PA-C
• Radiant Truth Counseling, LLC
• Julie Rae, L.AC.
• Elizabeth Anne Rakozy

• Mental Health Counselor in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.

Verify at the official NPI Registry.