NPIMap

Organization Active NPI

East Valley Trauma Counseling LLC

  • Clinical Social Worker
  • Gilbert, AZ
National Provider Identifier
1992227235
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16034 Issued in AZ
Legal business name
EAST VALLEY TRAUMA COUNSELING LLC
Practice address
1166 E Warner Rd Ste 206
Gilbert, AZ 85296-3066
Phone
(480) 462-7728
Fax
(480) 452-1530
NPI assigned
Jul 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Authorized official

Name
Stacy Deluca
Title
Billing Manager
Phone
(602) 741-3077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 16034 AZ Primary

Addresses

Primary practice location

1166 E Warner Rd Ste 206
Gilbert, AZ 85296-3066

Mailing address

3641 W Laredo St
Chandler, AZ 85226-2233
Phone (480) 776-4155

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1992227235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 W LAREDO ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262233",
            "telephone_number": "480-776-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 E WARNER RD STE 206",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963066",
            "telephone_number": "480-462-7728",
            "fax_number": "480-452-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY TRAUMA COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "DELUCA",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "602-741-3077"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "16034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.