INNOVATIVE THERAPEUTIC SERVICES (NPI# 1912495839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912495839 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE THERAPEUTIC SERVICES |
| Practice Address |
15600 N Black Canyon Hwy Ste C103 Phoenix AZ 85053-4055 |
| Mailing Address |
Po Box 86881 Phoenix AZ 85080-6881 |
| Practice Telephone | 6023207925 |
| Practice Fax Number | 8779589033 |
| Mailing Telephone | 6023207925 |
| Mailing Fax Number | 8779589033 |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |
| Authorized Official Name | DR. GWYNETTH ELAINE KELLY (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 6023207925 |
| Authorized Official Credential | DBH, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316337967 | Innovative Therapeutic Services | Social Worker | 44 N Potomac St, Hagerstown, MD 21740-4855 | 2015-02-03 |
| 1073903951 | Innovative Therapeutic Services | Community/Behavioral Health | 44 N Potomac St, Hagerstown, MD 21740-4855 | 2015-01-29 |
| 1548600174 | Innovative Therapeutic Services | Case Management | 755 S Main St, Raeford, NC 28376-3238 | 2013-06-27 |
| 1811331937 | Innovative Therapeutic Services | Community/Behavioral Health | 14440 Cherry Lane Ct, 208, Laurel, MD 20707-4946 | 2013-04-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | INNOVATIVE THERAPEUTIC SERVICES, INC. | 10940 South Parker Rd, #458, Parker, CO 80134 |
| Street Address |
15600 N BLACK CANYON HWY STE C103 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85053-4055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871065615 | Valley Addiction & Mental Health Services LLC | Nurse Practitioner | 16845 N. 29th Ave, Ste 1-211, Phoenix, AZ 85053 | 2018-12-18 |
| 1417439100 | Amanda M Sherwin | Dietitian, Registered | 15640 N 28h Drive, Phoenix, AZ 85053 | 2018-08-30 |
| 1568970135 | Sage Counseling, Inc. | Community/Behavioral Health | 2734 W Bell Rd., #1385 & 1390, Phoenix, AZ 85053 | 2018-01-17 |
| 1366966434 | Penny L Reamer | Registered Nurse | 17624 N. 31st Ave., Phoenix, AZ 85053 | 2017-08-01 |
| 1043749302 | Jacob Stephen Lawrence | Occupational Therapy Assistant | 3116 W. Hartford Dr., Phoenix, AZ 85053 | 2017-06-08 |
| 1770022923 | Horizon Dental Group West Valley | Dentist | 4025 W. Bell Road, Suite 20, Phoenix, AZ 85053 | 2017-02-21 |
| 1235594938 | Linda Thi Trinh | Optometrist | 16020 North 35th Ave Suite #2, Phoenix, AZ 85053 | 2015-12-22 |
| 1003230301 | Continuum Group West, LLC. | Clinic/Center | 3710 W Greenway Rd, Suite 104, Phoenix, AZ 85053 | 2014-02-07 |
| 1831539410 | Michelle Lea Byers | Nurse Practitioner | 17624 North 31st Ave, Phoenix, AZ 85053 | 2013-06-27 |
| 1437446580 | Candace Faith Gershkovich | Dentist | 4235 W. Thunderbird Rd, Phoenix, AZ 85053 | 2011-07-08 |
| Find all providers in zip 85053 | ||||
| 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.