Individual provider Active NPI

Adena Ray

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1992857304
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 3639 Issued in AZ
Practice address
868 E University Dr
Mesa, AZ 85203-8033
Phone
(480) 969-4024
NPI assigned
Jan 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCSW 3639 AZ Primary

Addresses

Primary practice location

868 E University Dr
Mesa, AZ 85203-8033

Mailing address

PO Box 5860
Mesa, AZ 85211-5860

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
I20140818002237 AZ Practitioner - Clinical Social Worker 1759508567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1646 N Litchfield Rd
Suite B 250
Goodyear, AZ 85395-1203
Phone 62397433334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 3639AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoran Life Solutions, Inc. CurrentSince Mar 20, 2019 Accepting new patients

Locations

1646 N Litchfield Rd
Ste B250
Goodyear, AZ 85395
Phone 62397433334

13460 N 94th Dr
Ste M1
Peoria, AZ 85381
Phone (623) 972-3131

8700 E Vista Bonita Dr
Ste 228
Scottsdale, AZ 85255
Phone (623) 974-3333

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992857304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5860",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852115860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038033",
            "telephone_number": "480-969-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ADENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW 3639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.