Nicole A Canchola, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-12926 Issued in AZ

Practice address

570 W Brown Rd
Mesa, AZ 85201-3227

Phone

(480) 344-2000

Fax

(480) 344-2000

NPI assigned

Dec 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lifespan Behavioral Health, LLC

  • Clinical Psychologist
  • Mesa, AZ
  • NPI 1033229281
  NPD (past)

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1932344512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013227",
            "telephone_number": "480-344-2000",
            "fax_number": "480-344-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013227",
            "telephone_number": "480-344-2000",
            "fax_number": "480-344-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCHOLA",
        "first_name": "NICOLE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Campos, LDO
• Taylor Christiana Campos, BCBA
• Canaan Capital Management LLC
• Salvador Canale, CCP
• Irma M. Canas, MNS, CCC-SLP
• Robert C Candipan, MD
• Hyrum Marriott Candland
• Canfield Counseling
• Diana Kay Canfield, MS, LCPC, LPC
• Amanda Rae Canizales, FNP

• Clinical Social Worker in Mesa, AZ
• Providers in Mesa, 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 12, 2010; 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.