Individual provider Active NPI

Lisa L McKirchy, LCSW

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1881218212
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13182 Issued in AZ
Practice address
525 W Brown Rd
Mesa, AZ 85201-3202
Phone
(602) 747-4772
NPI assigned
Jun 1, 2020
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 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 13182 AZ Primary

Addresses

Primary practice location

525 W Brown Rd
Mesa, AZ 85201-3202

Mailing address

957 E Magdalena Dr
Tempe, AZ 85283-3013
Phone (480) 734-1850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220919002754 AZ Practitioner - Clinical Social Worker 1456736982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Telehealth LLCGroup PAC ID 7113314279, 8 clinicians

Practice addresses (Care Compare)

7575 E Earll Dr
Suite 101
Scottsdale, AZ 85251-6915
Phone (480) 684-8345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13182AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Telehealth LLC CurrentSince May 6, 2022 Accepting new patients
Banner Telehealth LLC CurrentSince May 6, 2022 Accepting new patients

Locations

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

7575 E Earll Dr
Ste 101
Scottsdale, AZ 85251
Phone (480) 684-8345

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": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1881218212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 E MAGDALENA DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833013",
            "telephone_number": "480-734-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013202",
            "telephone_number": "602-747-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIRCHY",
        "first_name": "LISA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "13182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.