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

Staci Detwiler, MSW, LCSW

Individual provider Clinical Social Worker · NPI 1073248357

Staci Detwiler, MSW, LCSW is a Clinical Social Worker in Phoenix, Arizona. Qualified in 2020, 6 years ago. Practices with Fkl Enterprises LLC, a 15-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
6
Licensed in
AZ
In the registry since
2022
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
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

4646 E Greenway Rd Ste 100
Phoenix, AZ 85032-4805
Phone: (480) 674-9220
Fax: (480) 674-9231
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-22553 (AZ)

Record details

NPI number1073248357
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LCSW
Sole proprietorYes
NPI enumeratedJuly 20, 2022
Last updated in NPPESFebruary 19, 2025
Certification dateFebruary 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Fkl Enterprises Llc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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