Individual provider Active NPI

Kyrie Ann Conseen, LCSW

  • Clinical Social Worker
  • Peoria, AZ
National Provider Identifier
1568639649
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-12376 Issued in AZ
Practice address
14050 N 83Rd Ave
Ste 290
Peoria, AZ 85381-5650
Phone
(480) 349-1031
Fax
(480) 535-1510
NPI assigned
May 8, 2008
Last updated
Jul 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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-12376 AZ Primary

Addresses

Primary practice location

14050 N 83Rd Ave
Ste 290
Peoria, AZ 85381-5650

Mailing address

14050 N 83Rd Ave
Ste 290
Peoria, AZ 85381
Phone (480) 349-1031

Other identifiers 1

IdentifierTypeStateIssuer
329691MedicaidAZ

Other names 1

  • Ms. Lesley Ann Thompson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • 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
I20120330000415 AZ Practitioner - Clinical Social Worker 2466612361 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Clinical CurrentSince Sep 3, 2024 Accepting new patients
Satinder S. Purewal, M.D. LLC CurrentSince Sep 7, 2021 Accepting new patients
Headway Michigan Behavioral Health Services, P.C. CurrentSince Dec 18, 2024 Accepting new patients

Locations

6677 W Thunderbird Rd
Ste I164
Glendale, AZ 85306
Phone (623) 878-2100

1250 W Washington St
Ste 215
Tempe, AZ 85288
Phone (602) 842-7042

205 Hudson St
Fl 9
New York, NY 10013
Phone (516) 274-9095

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 3

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": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1568639649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE",
            "address_2": "STE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85381",
            "telephone_number": "480-349-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE",
            "address_2": "STE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815650",
            "telephone_number": "480-349-1031",
            "fax_number": "480-535-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSEEN",
        "first_name": "KYRIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329691",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLEY",
            "last_name": "THOMPSON",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.