Individual provider Active NPI

Stephanie Christine Kyle, LCSW

  • Clinical Social Worker
  • Peoria, AZ
National Provider Identifier
1619680402
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-20951 Issued in AZ
Practice address
8088 W Whitney Dr
Peoria, AZ 85345-6564
Phone
(602) 655-2000
Fax
(602) 655-2202
NPI assigned
Dec 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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-20951 AZ Primary

Addresses

Primary practice location

8088 W Whitney Dr
Peoria, AZ 85345-6564

Mailing address

2619 E Roosevelt St
Attn: Managed Care
Phoenix, AZ 85008

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
I20230119001049 AZ Practitioner - Clinical Social Worker 4385015940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-20951AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Maricopa County Special Health Care District CurrentSince Jan 11, 2023 Accepting new patients
Maricopa County Special Health Care District CurrentSince Jan 11, 2023 Accepting new patients
Maricopa County Special Health Care District Current Accepting new patients

Locations

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

2619 E Pierce St
Phoenix, AZ 85008
Phone (480) 344-2000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1619680402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 E ROOSEVELT ST",
            "address_2": "ATTN: MANAGED CARE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8088 W WHITNEY DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853456564",
            "telephone_number": "602-655-2000",
            "fax_number": "602-655-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "STEPHANIE",
        "middle_name": "CHRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-20951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.