Individual provider Active NPI

Andrea M Siemens, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1366900086
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17564 Issued in AZ
Practice address
2055 N Kolb Rd Ste 121
Tucson, AZ 85715-4099
Phone
(520) 838-0918
NPI assigned
Mar 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 17564 AZ Primary

Addresses

Primary practice location

2055 N Kolb Rd Ste 121
Tucson, AZ 85715-4099

Mailing address

2055 N Kolb Rd Ste 121
Tucson, AZ 85715-4099
Phone (520) 838-0918

Other identifiers 1

IdentifierTypeStateIssuer
17564OtherAZLCSW

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17564AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1366900086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N KOLB RD STE 121",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154099",
            "telephone_number": "520-838-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N KOLB RD STE 121",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154099",
            "telephone_number": "520-838-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMENS",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "17564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "17564",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.