Individual provider Active NPI

Melissa Marie Eastep, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1548614852
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW16939 Issued in AZ
Practice address
16251 N Cave Creek Rd
Phoenix, AZ 85032-2976
Phone
(480) 882-4545
Fax
(602) 409-0499
NPI assigned
Apr 22, 2016
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 15283 AZ
Clinical Social Worker 1041C0700X LCSW16939 AZ Primary

Addresses

Primary practice location

16251 N Cave Creek Rd
Phoenix, AZ 85032-2976

Mailing address

7500 N Dreamy Draw Dr Ste 145
Phoenix, AZ 85020-4668
Phone (480) 882-4545

Other practice location 1

6601 W Thomas Rd
Phoenix, AZ 85033-5700
Phone (602) 243-7277

Other practice location 2

2400 N Central Ave Ste 101
Phoenix, AZ 85004-1300
Phone (602) 264-9891

Other identifiers 1

IdentifierTypeStateIssuer
344208MedicaidAZ

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
I20180208003021 AZ Practitioner - Clinical Social Worker 6002176138 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW16939AZMDClinical Social Worker
15283AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince May 5, 2021 Accepting new patients
Sonoran Life Solutions, Inc. CurrentSince Apr 24, 2020 Accepting new patients

Locations

13460 N 94th Dr
Ste M1
Peoria, AZ 85381
Phone (623) 972-3131

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

8700 E Vista Bonita Dr
Ste 228
Scottsdale, AZ 85255
Phone (623) 974-3333

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1548614852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "602-409-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16251 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322976",
            "telephone_number": "480-882-4545",
            "fax_number": "602-409-0499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6601 W Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850335700",
            "country_code": "US",
            "telephone_number": "602-243-7277",
            "fax_number": "623-247-9742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 N Central Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850041300",
            "country_code": "US",
            "telephone_number": "602-264-9891",
            "fax_number": "602-234-2639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASTEP",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "15283",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW16939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344208",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.