Antonio Dacosta, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-0194 Issued in AZ

Practice address

4620 N 16TH St
Suite #E-110
Phoenix, AZ 85016-5121

Phone

(602) 264-2770

Fax

(866) 534-1701

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1851510812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 N 16TH ST",
            "address_2": "SUITE #E-110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165121",
            "telephone_number": "602-264-2770",
            "fax_number": "866-534-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 N 16TH ST",
            "address_2": "SUITE #E-110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165121",
            "telephone_number": "602-264-2770",
            "fax_number": "866-534-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "ANTONIO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "SW01941",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-0194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "721002",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• G. Paul Dabrowski, MD
• Michael P Dabrowski, DO
• Barbara Lohman Dabul, PHD
• Rhodel G. Dacanay, M.D.
• William Dachman, MD
• Kyana Marie Dacosta, LCSW
• Victoria E Dacosta, LMSW
• Pooja T Dadgar, MD
• Lisa Ann Dado, MD
• Brian Michael Daft, AGACNP

• 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 Mar 28, 2008; 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.