Individual provider Active NPI

Stephanie Amaris Portillo, LCSW

  • Clinical Social Worker
  • Avondale, AZ
National Provider Identifier
1912344656
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-15839 Issued in AZ
Practice address
235 W Western Ave
Avondale, AZ 85323-1848
Phone
(602) 230-7373
NPI assigned
Jun 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-13627 AZ
Clinical Social Worker 1041C0700X LCSW-15839 AZ Primary

Addresses

Primary practice location

235 W Western Ave
Avondale, AZ 85323-1848

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Other practice location 1

2701 E Camelback Rd
#155
Phoenix, AZ 85016-4309
Phone (602) 230-7373

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
I20151202001345 AZ Practitioner - Clinical Social Worker 1850691544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Denova Collaborative Health, LLCGroup PAC ID 2466437736, 141 clinicians

Practice addresses (Care Compare)

3033 N Central Ave
Suite 700
Phoenix, AZ 85012-2806
Phone (602) 230-7373

506 E Western Ave
Suite 104
Avondale, AZ 85323-2422
Phone (602) 230-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-13627AZMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince Dec 1, 2015 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Dec 1, 2015 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients

Locations

235 W Western Ave
Avondale, AZ 85323
Phone (623) 772-5091

506 E Western Ave
Ste 104
Avondale, AZ 85323

2120 W Guadalupe Rd
Ste 6
Mesa, AZ 85202
Phone (480) 629-8577

2204 S Dobson Rd
Ste 201
Mesa, AZ 85202
Phone (602) 374-4410

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

3330 N 2nd St
Ste 601
Phoenix, AZ 85012
Phone (602) 234-3444

3620 N 3rd St
Phoenix, AZ 85012
Phone (602) 329-8250

3300 N Central Ave
Ste 700
Phoenix, AZ 85012

77 E Columbus Ave
Ste 210
Phoenix, AZ 85012

926 E McDowell Rd
Ste 123
Phoenix, AZ 85006
Phone (602) 323-0737

750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455

926 E McDowell Rd
Ste 105
Phoenix, AZ 85006
Phone 6022307373229

750 E Thunderbird Rd
Ste 1
Phoenix, AZ 85022
Phone (602) 942-8512

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

9014 S Central Ave
Phoenix, AZ 85042
Phone (602) 384-8820

6565 E Carondelet Dr
Ste 215
Tucson, AZ 85710
Phone (520) 547-1887

Organizations & group practices 3

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1912344656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W WESTERN AVE",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231848",
            "telephone_number": "602-230-7373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 E Camelback Rd",
            "address_2": "#155",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164309",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "STEPHANIE",
        "middle_name": "AMARIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-13627",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-15839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.