ANTONIO DACOSTA (NPI# 1851510812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851510812 |
| Entity Type | Individual |
| Full Name | ANTONIO DACOSTA |
| Credential | LCSW |
| Practice Address |
4620 N 16th St Suite #e-110 Phoenix AZ 85016-5121 |
| Practice Telephone | 6022642770 |
| Practice Fax Number | 8665341701 |
| Mailing Telephone | 6022642770 |
| Mailing Fax Number | 8665341701 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2008-03-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | SW01941 | AZ | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-0194 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 721002 | 05 |
| Street Address |
4620 N 16TH ST SUITE #E-110 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-5121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902978463 | Jill Zwaska | Social Worker | 4620 N 16th St, E110, Phoenix, AZ 85016-5121 | 2006-11-13 |
| 1053657361 | Genesis Medical Practice Management | Psychologist | 4620 N 16th St, E-110, Phoenix, AZ 85016-5121 | 2012-12-14 |
| 1548491350 | Arizona Behavioral Home Health Services LLC | Psychologist | 4620 N 16th St, E-110, Phoenix, AZ 85016-5121 | 2009-07-29 |
| 1679709646 | Jeff C Reed | Counselor | 4620 N 16th St, Suite E-110, Phoenix, AZ 85016-5121 | 2009-06-04 |
| 1891965810 | Elaine M Katzman | Nurse Practitioner | 4620 N 16th St, Suite #e-110, Phoenix, AZ 85016-5121 | 2008-03-05 |
| 1073782884 | Charles Brady Dalton | Psychologist | 4620 N 16th St, Suite #e-110, Phoenix, AZ 85016-5121 | 2008-02-26 |
| 1518166453 | Shirvan, Inc. | Durable Medical Equipment & Medical Supplies | 4620 N 16th St, B-209, Phoenix, AZ 85016-5121 | 2007-07-12 |
| 1528184959 | Grace of Serenity Living, Inc | Community/Behavioral Health | 4620 N 16th St, A-101, Phoenix, AZ 85016-5121 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1376141697 | Kristen Beuchat Alaniz | Social Worker | 2520 W Brookhart Way, Phoenix, AZ 85085-3725 | 2020-10-09 |
| 1780281659 | Robin Slavit | Social Worker | 5550 E Deer Valley Dr Apt 426, Phoenix, AZ 85054-5673 | 2020-10-05 |
| 1053934554 | Andrea Durand | Social Worker | 1918 W Bonanza Ln, Phoenix, AZ 85085-1727 | 2020-05-19 |
| 1841819125 | Hohokimel Thwajik Ki, LLC | Social Worker | 4114 N 28th St Apt 3005, Phoenix, AZ 85016-5779 | 2020-04-16 |
| 1104459973 | Ingrid Roxana Mejia | Social Worker | 1038 E Colter St, Phoenix, AZ 85014-2622 | 2020-02-19 |
| 1710533435 | Traci Andes | Social Worker | 8841 N 1st St Ste B, Phoenix, AZ 85020-2801 | 2019-08-18 |
| 1477107308 | Ralph Crudup Jr. | Social Worker | 6149 N 23rd Ave, Phoenix, AZ 85015-1821 | 2019-07-29 |
| 1255896593 | Cindy Eileen Penka-shack | Social Worker | 4531 E Danbury Rd, Phoenix, AZ 85032-2367 | 2019-01-31 |
| 1346723368 | Nathan Rehm | Social Worker | 3332 N 25th St, Phoenix, AZ 85016-7425 | 2018-09-14 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.