Individual provider Active NPI

Joy Anna Ifill, MSW, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1790048395
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4065-C Issued in NV
Practice address
1641 E Flamingo Rd
Suite 7
Las Vegas, NV 89119-5257
Phone
(702) 434-1564
Fax
(702) 434-6704
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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 4065-C NV Primary

Addresses

Primary practice location

1641 E Flamingo Rd
Suite 7
Las Vegas, NV 89119-5257

Mailing address

1641 E Flamingo Rd
Suite 7
Las Vegas, NV 89119-5257
Phone (702) 434-1564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20241115000754 MA Practitioner - Clinical Social Worker 7810421658 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4065-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Network Inc CurrentSince Sep 6, 2024 Accepting new patients
Behavioral Health Network, Inc CurrentSince Sep 6, 2024 Accepting new patients

Locations

40 Bobala Rd
Holyoke, MA 01040
Phone (413) 536-5473

417 Liberty St
Springfield, MA 01104
Phone (413) 733-6661

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1790048395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 E FLAMINGO RD",
            "address_2": "SUITE 7",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195257",
            "telephone_number": "702-434-1564",
            "fax_number": "702-434-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E FLAMINGO RD",
            "address_2": "SUITE 7",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195257",
            "telephone_number": "702-434-1564",
            "fax_number": "702-434-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFILL",
        "first_name": "JOY",
        "middle_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "4065-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.