Individual provider Active NPI

Shawntae Stevenson, LCSW

  • Social Worker
  • Mesa, AZ
National Provider Identifier
1659736098
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW-23328 Issued in AZ
Practice address
1910 S Stapley Dr Ste 120
Mesa, AZ 85204-6676
Phone
(520) 447-1606
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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 095374-1 NY
Social Worker 104100000X LCSW-23328 AZ Primary

Addresses

Primary practice location

1910 S Stapley Dr Ste 120
Mesa, AZ 85204-6676

Mailing address

1910 S Stapley Dr Ste 120
Mesa, AZ 85204-6676
Phone (520) 447-1606

Other practice location 1

1 Gustave L Levy Place
Mount Sinai Hospital
New York, NY 10029-6574
Phone (206) 841-2665

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
I20251229002846 AZ Practitioner - Clinical Social Worker 0840786810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1435 E Divot Dr
Tempe, AZ 85283-4862

1910 S Stapley Dr
Suite 120
Mesa, AZ 85204-6676

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

PO Box
Minneapolis, MN 55486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-23328AZMDSocial Worker
095374-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Poised Clinical Consulting Current Accepting new patients
Mayo Clinic Arizona CurrentSince Dec 15, 2025 Accepting new patients
Poised Clinical Consulting Current Accepting new patients
Mayo Clinic Arizona CurrentSince Dec 15, 2025 Accepting new patients

Locations

13400 E Shea Blvd
Scottsdale, AZ 85259

Organizations & group practices 4

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": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1659736098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 120",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046676",
            "telephone_number": "520-447-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 120",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046676",
            "telephone_number": "520-447-1606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L Levy Place",
            "address_2": "Mount Sinai Hospital",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296574",
            "country_code": "US",
            "telephone_number": "206-841-2665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "SHAWNTAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "095374-1",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LCSW-23328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.