Individual provider Active NPI

Sherry Lynn Kauffman, LCSW

  • Clinical Social Worker
  • Davis Monthan Afb, AZ
National Provider Identifier
1356490072
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006459 Issued in VA
Practice address
3345 S 1St St BLDG 1358
Davis Monthan Afb, AZ 85707-4007
Phone
(520) 228-1026
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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 0904006459 VA Primary

Addresses

Primary practice location

3345 S 1St St BLDG 1358
Davis Monthan Afb, AZ 85707-4007

Mailing address

11445 E Squash Blossom Loop
Tucson, AZ 85747-6224
Phone (520) 528-5685

Other practice location 1

11445 E Squash Blossom Loop
Tucson, AZ 85747-6224
Phone (703) 766-5040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904006459VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1356490072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11445 E SQUASH BLOSSOM LOOP",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857476224",
            "telephone_number": "520-528-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 S 1ST ST BLDG 1358",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074007",
            "telephone_number": "520-228-1026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11445 E Squash Blossom Loop",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857476224",
            "country_code": "US",
            "telephone_number": "703-766-5040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "SHERRY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis Monthan Afb, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.