MEDICARE: AMY SWORD RUFFIN 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-22506	AZ

General Provider Information

NPI Number	:	1437974003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY SWORD RUFFIN LCSW

Provider Business Mailing Address
First Line	:	10453 E IDAHO CIR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85209-7715
Country	:	US
Telephone Number	:	480-875-5305
Fax Number	:

Provider Business Practice Location Address
First Line	:	4020 N 20TH ST STE 110
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-6029
Country	:	US
Telephone Number	:	602-640-2981
Fax Number	:

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

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	06/15/2026

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