Individual provider Active NPI

Tiffany A Zenk, LCSW

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1073286605
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-19659 Issued in AZ
Practice address
1111 S Stapley Dr
Mesa, AZ 85204-5059
Phone
(602) 685-6000
Fax
(480) 834-5703
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-19659 AZ Primary

Addresses

Primary practice location

1111 S Stapley Dr
Mesa, AZ 85204-5059

Mailing address

3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210804004110 AZ Practitioner - Clinical Social Worker 0840694303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Terros, Inc. CurrentSince Dec 6, 2023 Accepting new patients
Terros, Inc. Current Accepting new patients

Locations

1111 S Stapley Dr
Mesa, AZ 85204
Phone (480) 464-6802

3003 N Central Ave
Ste 400
Phoenix, AZ 85012
Phone (602) 351-3015

4909 E McDowell Rd
Phoenix, AZ 85008
Phone (602) 244-9591

Interoperability endpoints

  • Direct secure messaging: tiffany.sorensen.p1@direct.terros.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1073286605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045059",
            "telephone_number": "602-685-6000",
            "fax_number": "480-834-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENK",
        "first_name": "TIFFANY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-19659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.