Individual provider Active NPI

Tallia Lenore Doyle, LCSW

  • Clinical Social Worker
  • Surprise, AZ
National Provider Identifier
1508588351
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-16938 Issued in AZ
Practice address
12211 W Bell Rd Ste 106
Surprise, AZ 85378-9655
Phone
(480) 808-5051
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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
Clinical Social Worker 1041C0700X LCSW-16938 AZ Primary

Addresses

Primary practice location

12211 W Bell Rd Ste 106
Surprise, AZ 85378-9655

Mailing address

2915 E Baseline Rd Ste 115
Gilbert, AZ 85234-2427
Phone (480) 641-9552

Other practice location 1

715 E Park Ave
Chandler, AZ 85225-1757
Phone (480) 251-5544

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

LicenseStateTypeSpecialty
LCSW-16938AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1508588351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 E BASELINE RD STE 115",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342427",
            "telephone_number": "480-641-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12211 W BELL RD STE 106",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789655",
            "telephone_number": "480-808-5051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 E Park Ave",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852251757",
            "country_code": "US",
            "telephone_number": "480-251-5544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "TALLIA",
        "middle_name": "LENORE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-16938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.