Individual provider Active NPI

Kathleen Mae Lazarick

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1932893625
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15270 Issued in AZ
Practice address
10434 E Jan Ave
Mesa, AZ 85209-7729
Phone
(609) 618-8090
NPI assigned
Jun 6, 2023
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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 15270 AZ Primary

Addresses

Primary practice location

10434 E Jan Ave
Mesa, AZ 85209-7729

Mailing address

10434 E Jan Ave
Mesa, AZ 85209-7729
Phone (609) 618-8090

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
I20231003003614 AZ Practitioner - Clinical Social Worker 1456705896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1760 E Pecos Rd
Suite 344
Gilbert, AZ 85295-3208
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15270AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Mar 20, 2024 Accepting new patients

Locations

1760 E Pecos Rd
Ste 344
Gilbert, AZ 85295
Phone (480) 613-3817

4801 S Lakeshore Dr
Ste 207
Tempe, AZ 85282
Phone (562) 659-0950

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 1

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1932893625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10434 E JAN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852097729",
            "telephone_number": "609-618-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10434 E JAN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852097729",
            "telephone_number": "609-618-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARICK",
        "first_name": "KATHLEEN",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "15270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.