Jennelle Staub

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22773 Issued in AZ

Practice address

2632 E Thomas Rd Ste 100
Phoenix, AZ 85016-8220

Phone

(602) 957-2507

NPI assigned

Nov 6, 2025

Last updated

Nov 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southwest Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1144384389
  Medicare reassignment
• Southwest Behavioral Health Service

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Buckeye, AZ
  • NPI 1104030980
  NPD
• Southwest Behavioral Health Services, Inc.

  • Psychiatric Residential Treatment Facility
  • Kingman, AZ
  • NPI 1023556339
  NPD

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1639049620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122331",
            "telephone_number": "602-265-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 E THOMAS RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168220",
            "telephone_number": "602-957-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUB",
        "first_name": "JENNELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "22773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of the Art Chiropractic Center
• John Stathakis, DO
• Taylor Nicole Statler, BCBA
• Brittney Staton, SLPA
• Justin Edward Statt, DO
• Trevor Michael Staub, M.D.
• Sarah Bess Stauffer, OTD, OTR/L
• Lindsay A Stauss, PA C
• Kylie Stava
• Eric D Stavoe, D.D.S.

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.