Active NPI
Mary Ann De Guzman, LCSW
- Counselor
- Phoenix, AZ
National Provider Identifier
1669011748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 17508
- Practice address
- 650 E Indian School Rd
Phoenix, AZ 85012-1839 - Phone
- (602) 277-5551
- NPI assigned
- Jan 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 17508 | AZ | Primary |
Addresses
Primary practice location
650 E Indian School Rd
Phoenix, AZ 85012-1839
Mailing address
15122 W Roma Ave
Goodyear, AZ 85395-6349
Phone (808) 368-7887
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | HIE | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17508 | AZ | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Current | Accepting new patients |
Locations
4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490
Organizations & group practices 1
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": "1578268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578268800000",
"number": "1669011748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15122 W ROMA AVE",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853956349",
"telephone_number": "808-368-7887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E INDIAN SCHOOL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850121839",
"telephone_number": "602-277-5551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE GUZMAN",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-06",
"last_updated": "2020-01-06",
"certification_date": "2020-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "17508",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "HIE",
"affiliation": "N",
"endpointDescription": "Health Information Exchange in various methods",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct messaging, other URL",
"address_1": "650 E Indian School Rd",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850121839",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.