Individual provider Active NPI

Elizabeth Marie Patterson, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1700156940
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-17419 Issued in AZ
Practice address
2633 E Indian School Rd Ste 360
Phoenix, AZ 85016-6777
Phone
(602) 285-9696
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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-17419 AZ Primary

Addresses

Primary practice location

2633 E Indian School Rd Ste 360
Phoenix, AZ 85016-6777

Mailing address

4121 E Valley Auto Dr Ste 122
Mesa, AZ 85206-4632
Phone (602) 285-9696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140123000793 MI Practitioner - Clinical Social Worker 4688802572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kalamazoo County Community Mental Health AuthorityGroup PAC ID 5890730337, 38 clinicians

Practice addresses (Care Compare)

615 E Crosstown Pkwy
Kalamazoo, MI 49001-2501
Phone (269) 373-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo County Community Mental Health Authority CurrentSince Oct 5, 2021 Accepting new patients
Kalamazoo County Community Mental Health Authority CurrentSince Oct 5, 2021 Accepting new patients

Locations

2030 Portage St
Kalamazoo, MI 49001
Phone (269) 553-7132

615 E Crosstown Pkwy
Kalamazoo, MI 49001
Phone (269) 373-6000

Organizations & group practices 2

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": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1700156940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DR STE 122",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064632",
            "telephone_number": "602-285-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 E INDIAN SCHOOL RD STE 360",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166777",
            "telephone_number": "602-285-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-17419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.