Individual provider Active NPI

Merrill R. Heslop, L.C.S.W.

  • Clinical Social Worker
  • Queen Creek, AZ
National Provider Identifier
1467438929
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-2817 Issued in AZ
Practice address
20185 E Ocotillo Rd
#105
Queen Creek, AZ 85242-8799
Phone
(480) 987-2700
Fax
(480) 987-2703
NPI assigned
Dec 16, 2005
Last updated
Jun 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-2817 AZ Primary

Addresses

Primary practice location

20185 E Ocotillo Rd
#105
Queen Creek, AZ 85242-8799

Mailing address

20185 E Ocotillo Rd
#105
Queen Creek, AZ 85242-8799
Phone (480) 987-2700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051004000297 AZ Practitioner - Clinical Social Worker 9739114448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1467438929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20185 E OCOTILLO RD",
            "address_2": "#105",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852428799",
            "telephone_number": "480-987-2700",
            "fax_number": "480-987-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20185 E OCOTILLO RD",
            "address_2": "#105",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852428799",
            "telephone_number": "480-987-2700",
            "fax_number": "480-987-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESLOP",
        "first_name": "MERRILL",
        "middle_name": "R.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-2817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.