Healthcare Provider Details

I. General information

NPI: 1912693102
Provider Name (Legal Business Name): ERICK ESCALERA LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 N SCOTTSDALE RD
SCOTTSDALE AZ
85257-3411
US

IV. Provider business mailing address

1375 N SCOTTSDALE RD
SCOTTSDALE AZ
85257-3411
US

V. Phone/Fax

Practice location:
  • Phone: 602-813-7272
  • Fax:
Mailing address:
  • Phone: 480-568-0882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number21910
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: