Tina Jane Adams, LCSW, MSW, BHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17130 Issued in AZ

Practice address

2717 N 4TH St Ste 23a
Flagstaff, AZ 86004-1847

Phone

(928) 606-5306

Fax

(928) 527-3119

NPI assigned

Jul 4, 2018

Last updated

Feb 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  AZ

  Medicare reassignment NPD

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1497241228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 BUCKBOARD TRL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860045287",
            "telephone_number": "928-606-5306",
            "fax_number": "928-527-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 N 4TH ST STE 23A",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041847",
            "telephone_number": "928-606-5306",
            "fax_number": "928-527-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "TINA",
        "middle_name": "JANE",
        "credential": "LCSW, MSW, BHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-04",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "17130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aces Dental of Flagstaff
• Christina Ann Acheson-Hayes, L.C.S.W.
• Lorraine Bernice Acheson
• Melissa A Acquaviva, CRNA
• Sandra Lee Adams, NP
• ADHD Clinics of Arizona
• Cynthia Adson, ARNP, FNPBC
• Advanced Anesthesia Group, LLC
• Adventure Discovery Inc
• Michelle R Aerni, D.O.

• Clinical Social Worker in Flagstaff, AZ
• Providers in Flagstaff, 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 Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.