Benjamin Joseph De Jesus, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW 16081 Issued in AZ

Practice address

2120 S McClintock Dr Ste 105
Tempe, AZ 85282-2692

Phone

(480) 804-0326

NPI assigned

Feb 20, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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 and National Provider Directory roles.

• Crisis Preparation and Recovery, Inc

  • Community/Behavioral Health Agency
  • Tempe, AZ
  • NPI 1912270422
  Medicare reassignment NPD
• The Act of Healing LLC

  • Clinical Social Worker
  • Gilbert, AZ
  • NPI 1174979603
  NPD (past) Authorized official

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1649695164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 E WARNER RD STE 101T",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963065",
            "telephone_number": "480-375-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 S MCCLINTOCK DR STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822692",
            "telephone_number": "480-804-0326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1166 E Warner Rd Ste 101T",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852963065",
            "country_code": "US",
            "telephone_number": "480-375-1317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "BENJAMIN",
        "middle_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-20",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW 16081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171168",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonard Days, MA, LISAC
• Almi Dayshi, CNA
• DB Medical
• DCR Anesthesia PC
• Anna De Jesus, RDN
• Rachelly De la Cruz, RN
• Ginno De Leon, PMHNP-BC
• Marie Grace De Leon, PMHNP
• Tyler Xavier De Souza, O.D.
• Natasha De Soysa

• Clinical Social Worker in Tempe, AZ
• Providers in Tempe, 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 Oct 22, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.