Individual provider Active NPI

Genett Andrea Tomko, MSW, LCSW, IMH-E III

  • Clinical Social Worker
  • Chandler, AZ
National Provider Identifier
1467783340
Registry record updated Jan 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-12770 Issued in AZ
Practice address
825 W Warner Rd
Chandler, AZ 85225-2926
Phone
(480) 650-0209
NPI assigned
Jan 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2010

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-12770 AZ Primary

Addresses

Primary practice location

825 W Warner Rd
Chandler, AZ 85225-2926

Mailing address

6409 S Dorsey LN
Tempe, AZ 85283-3910
Phone (480) 650-0209

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
LCSW-12770AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ground Work Clinical Past Accepting new patients

Organizations & group practices 1

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": "1263686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263686400000",
    "number": "1467783340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6409 S DORSEY LN",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833910",
            "telephone_number": "480-650-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W WARNER RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252926",
            "telephone_number": "480-650-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMKO",
        "first_name": "GENETT",
        "middle_name": "ANDREA",
        "credential": "MSW, LCSW, IMH-E III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-17",
        "last_updated": "2010-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2010; 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.