Active NPI
Jacquelyn J Goodluck, LMSW
- Social Worker
- Phoenix, AZ
National Provider Identifier
1487374310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-20059
- Practice address
- 400 North 32ND Street
Phoenix, AZ 85008 - Phone
- (602) 914-2900
- NPI assigned
- Aug 31, 2022
- Last updated
- Aug 31, 2022
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-20059 | AZ | Primary |
Addresses
Primary practice location
400 North 32ND Street
Phoenix, AZ 85008
Mailing address
400 N 32ND St
Phoenix, AZ 85008-6205
Phone (602) 914-2900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-20059 | AZ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661904000000",
"number": "1487374310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N 32ND ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850086205",
"telephone_number": "602-914-2900",
"fax_number": "602-200-2329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 NORTH 32ND STREET",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85008",
"telephone_number": "602-914-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODLUCK",
"first_name": "JACQUELYN",
"middle_name": "J",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-31",
"last_updated": "2022-08-31",
"certification_date": "2022-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "LMSW-20059",
"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 Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.