Jody Lynn Tierney, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10616 Issued in AZ

Practice address

9405 S Avenida del Yaqui
Guadalupe, AZ 85283-2529

Phone

(480) 780-2024

Fax

(480) 768-2053

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194939124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 S AVENIDA DEL YAQUI",
            "city": "GUADALUPE",
            "state": "AZ",
            "postal_code": "852832529",
            "telephone_number": "480-780-2024",
            "fax_number": "480-768-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 S AVENIDA DEL YAQUI",
            "city": "GUADALUPE",
            "state": "AZ",
            "postal_code": "852832529",
            "telephone_number": "480-780-2024",
            "fax_number": "480-768-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "10616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "854580",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pascua Yaqui Tribe
• Gloria M Rosales, LISAC
• Grant Satterthwaite
• Michael N. Shanley, LCSW, LISAC
• Michael Kevin Simonetti
• Oghenetega Ewefada Vance, FNP
• David T Wilson, DO
• Qi Wen Xin, D.O.

• Clinical Social Worker in Guadalupe, AZ
• Providers in Guadalupe, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.