Individual provider Active NPI

Heather Derosia, MSSW

  • Clinical Social Worker
  • Goodyear, AZ
National Provider Identifier
1932763083
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LMSW-21034 Issued in AZ
Practice address
1626 N Litchfield Rd Ste 200
Goodyear, AZ 85395-1254
Phone
(615) 924-9205
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LMSW-21034 AZ Primary

Addresses

Primary practice location

1626 N Litchfield Rd Ste 200
Goodyear, AZ 85395-1254

Mailing address

4539 N 22ND St Ste R
Phoenix, AZ 85016-4639
Phone (615) 924-9205

Other identifiers 1

IdentifierTypeStateIssuer
330000014MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-21034AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1932763083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4539 N 22ND ST STE R",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164639",
            "telephone_number": "615-924-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 N LITCHFIELD RD STE 200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951254",
            "telephone_number": "615-924-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSIA",
        "first_name": "HEATHER",
        "credential": "MSSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LMSW-21034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000014",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.