Individual provider Active NPI

Freddy Bernardino

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1760188866
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1500 E Thomas Rd Ste 106
Phoenix, AZ 85014-5748
Phone
(602) 802-3552
NPI assigned
Feb 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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 AZ Primary

Addresses

Primary practice location

1500 E Thomas Rd Ste 106
Phoenix, AZ 85014-5748

Mailing address

7620 S 68TH Dr
Laveen, AZ 85339-2747
Phone (602) 802-3552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1760188866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 S 68TH DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392747",
            "telephone_number": "602-802-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E THOMAS RD STE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145748",
            "telephone_number": "602-802-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDINO",
        "first_name": "FREDDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.