Ethelyn Lara, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-19732 Issued in AZ

Practice address

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Phone

(602) 933-0990

Fax

(602) 933-4251

NPI assigned

May 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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.

• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Childhelp, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1124107065
  NPD (past)

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1699264887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0990",
            "fax_number": "602-933-4251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 N Central Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850041454",
            "country_code": "US",
            "telephone_number": "602-271-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARA",
        "first_name": "ETHELYN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-19732",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "16318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Whitmer Laprade Jr., MD
• Kevin Lynn Lapratt, M.S. OTR/L
• Nancy Lapratt
• Ana Maria Lara, NMD
• Dulce Migdalia Lara
• Jose Lara, D.C.
• Nina Jeanette Lara, M.D.
• Noelle Lara
• Victor Agustin Lara, MD
• Debora Larabee

• 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 15, 2021; 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.