Individual provider Active NPI

Bonner Presbrey Raskob, MSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1578723425
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW1641I Issued in AZ
Practice address
6738 E Kiami St
Tucson, AZ 85715-3324
Phone
(520) 792-1450
NPI assigned
Jun 13, 2008
Last updated
Jun 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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 SW1641I AZ Primary

Addresses

Primary practice location

6738 E Kiami St
Tucson, AZ 85715-3324

Mailing address

6738 E Kiami St
Tucson, AZ 85715-3324
Phone (520) 792-1450

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW1641IAZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cope Community Services, Inc. Past Accepting new patients
Cope Community Services, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1578723425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6738 E KIAMI ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153324",
            "telephone_number": "520-792-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6738 E KIAMI ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153324",
            "telephone_number": "520-792-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASKOB",
        "first_name": "BONNER",
        "middle_name": "PRESBREY",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "SW1641I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.