=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437808425
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MILITZA MONGE CORTES LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2022
-----------------------------------------------------
Last Update Date | 07/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11851 N 51ST AVE STE F140
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85304-2847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-882-4545
-----------------------------------------------------
Fax | 623-242-1314
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7500 N DREAMY DRAW DR STE 145
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85020-4668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-882-4545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCSW23153
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------