Active NPI
Mary Elmore
- Clinical Social Worker
- Phoenix, AZ
National Provider Identifier
1942607346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4043
- Practice address
- 1320 E Paradise LN
Phoenix, AZ 85022-3201 - Phone
- (602) 692-3015
- Fax
- (480) 659-7230
- NPI assigned
- Dec 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4043 | AZ | Primary |
Addresses
Primary practice location
1320 E Paradise LN
Phoenix, AZ 85022-3201
Mailing address
1320 E Paradise LN
Phoenix, AZ 85022-3201
Phone (602) 692-3015
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4043 | Other | AZ | STATE LICENSE NUMBER |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1942607346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 E PARADISE LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850223201",
"telephone_number": "602-692-3015",
"fax_number": "480-659-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 E PARADISE LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850223201",
"telephone_number": "602-692-3015",
"fax_number": "480-659-7230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELMORE",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-01",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "4043",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "4043",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.