MEDICARE: MS. JOAN P. DEWEY 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-18507	AZ

General Provider Information

NPI Number	:	1093925406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOAN P. DEWEY LCSW

Provider Business Mailing Address
First Line	:	2763 TOHO TRL
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86005-3753
Country	:	US
Telephone Number	:	928-606-7526
Fax Number	:	928-606-7526

Provider Business Practice Location Address
First Line	:	2763 TOHO TRL
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86005-3753
Country	:	US
Telephone Number	:	928-606-7526
Fax Number	:	928-606-7526

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	10/01/2025

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