Individual provider Active NPI

Krista L Sheldon, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1689740847
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-10462 Issued in AZ
Practice address
3141 N 3Rd Ave
Phoenix, AZ 85013-4360
Phone
(602) 914-1520
Fax
(602) 266-0545
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 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-10462 AZ Primary

Addresses

Primary practice location

3141 N 3Rd Ave
Phoenix, AZ 85013-4360

Mailing address

15550 N Frank Lloyd Wright Blvd Unit 1056
Scottsdale, AZ 85260-2034
Phone (602) 717-1182

Other names 1

  • Krista L Fancy Former name

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
I20180813003226 AZ Practitioner - Clinical Social Worker 2365790052 Reassigns benefits to 1 organization
Practice locations: Scottsdale, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

20 E Thomas Rd
Suite 2200
Phoenix, AZ 85012-3133
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jun 13, 2023 Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1689740847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15550 N FRANK LLOYD WRIGHT BLVD UNIT 1056",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602034",
            "telephone_number": "602-717-1182",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 N 3RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134360",
            "telephone_number": "602-914-1520",
            "fax_number": "602-266-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "KRISTA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-10462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "FANCY",
            "middle_name": "L",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.