Healthcare Provider Details

I. General information

NPI: 1104327568
Provider Name (Legal Business Name): GERDA PHILLIPS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GERDA SWORTZEL LMSW

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 W DUNLAP AVE STE 300
PHOENIX AZ
85021-2822
US

IV. Provider business mailing address

3003 N CENTRAL AVE STE 200
PHOENIX AZ
85012-2914
US

V. Phone/Fax

Practice location:
  • Phone: 602-685-6000
  • Fax: 602-943-4284
Mailing address:
  • Phone: 602-685-6000
  • Fax: 602-685-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-17018
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: