Healthcare Provider Details

I. General information

NPI: 1437974003
Provider Name (Legal Business Name): AMY SWORD RUFFIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY SWORD LCSW, MSW

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 N 20TH ST STE 110
PHOENIX AZ
85016-6029
US

IV. Provider business mailing address

10453 E IDAHO CIR
MESA AZ
85209-7715
US

V. Phone/Fax

Practice location:
  • Phone: 602-640-2981
  • Fax:
Mailing address:
  • Phone: 480-875-5305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-22506
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: