MEDICARE: WENDY CHANDROSS MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW-10960	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669579603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY CHANDROSS MSW, LCSW

Provider Business Mailing Address
First Line	:	21001 N TATUM BLVD STE 1630-190
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-4206
Country	:	US
Telephone Number	:	602-571-1978
Fax Number	:

Provider Business Practice Location Address
First Line	:	22307 N 39TH WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-5428
Country	:	US
Telephone Number	:	602-571-1978
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/25/2025

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