Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Rundall, LCSW

Individual provider Social Worker · NPI 1205421229

Jacob Rundall, LCSW is a Social Worker in Phoenix, Arizona. Licensed in Arizona and New Mexico. Registered with an NPI since 2021.

Licensed in
AZ, NM
In the registry since
2021
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

3231 W Shangri La Rd
Phoenix, AZ 85029-4151
Phone: (563) 639-4787
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence LCSW-21992 (AZ)
Social Worker Taxonomy 104100000X · Licence SWB-2024-0480 (NM)

Record details

NPI number1205421229
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 2, 2021
Last updated in NPPESMarch 11, 2026
Certification dateMarch 11, 2026

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