Individual provider Active NPI

Tammy W Cabrera, LCSW

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1740501808
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 11506 Issued in AZ
Practice address
4111 E Valley Auto Dr Ste 201
Mesa, AZ 85206-4609
Phone
(602) 618-5530
NPI assigned
Jun 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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 11506 AZ Primary

Addresses

Primary practice location

4111 E Valley Auto Dr Ste 201
Mesa, AZ 85206-4609

Mailing address

1893 W Encinas St
Gilbert, AZ 85233-2314
Phone (602) 618-5530

Other practice location 1

1893 W Encinas St
Gilbert, AZ 85233-2314
Phone (602) 618-5530

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210827001409 AZ Practitioner - Clinical Social Worker 1557410248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4111 E Valley Auto Dr
Suite 201
Mesa, AZ 85206-4609
Phone (480) 604-6539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 11506AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TWC Counseling Clinical CurrentSince Jul 25, 2021 Accepting new patients

Locations

4111 E Valley Auto Dr
Ste 201
Mesa, AZ 85206
Phone (480) 666-5502

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1740501808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 W ENCINAS ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852332314",
            "telephone_number": "602-618-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR STE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064609",
            "telephone_number": "602-618-5530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1893 W Encinas St",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852332314",
            "country_code": "US",
            "telephone_number": "602-618-5530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "TAMMY",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2021-07-15",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW 11506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.