Individual provider Active NPI

Jeffery Taylor, LCSW

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1467627703
Registry record updated Dec 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15351 Issued in AZ
Practice address
1910 S Stapley Dr Ste 209
Mesa, AZ 85204-6679
Phone
(480) 351-8020
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2025

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 15351 AZ Primary

Addresses

Primary practice location

1910 S Stapley Dr Ste 209
Mesa, AZ 85204-6679

Mailing address

6762 S Haunted Canyon Rd
Gold Canyon, AZ 85118-4760
Phone (480) 667-3325

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
I20150420001835 AZ Practitioner - Clinical Social Worker 4789902982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

1910 S Stapley Dr
Suite 209
Mesa, AZ 85204-6679
Phone (888) 362-5953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15351AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Mental Health CurrentSince Jan 4, 2026 Accepting new patients

Locations

1910 S Stapley Dr
Ste 209
Mesa, AZ 85204
Phone (480) 351-8020

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765584000000",
    "number": "1467627703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6762 S HAUNTED CANYON RD",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851184760",
            "telephone_number": "480-667-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "480-351-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JEFFERY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2025-12-13",
        "certification_date": "2025-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "15351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.