Active NPI
Christine A Widener, LCSW
- Clinical Social Worker
- Tucson, AZ
National Provider Identifier
1750641569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-13083
- Practice address
- 240 N Court Ave
Tucson, AZ 85701 - Phone
- (520) 904-5113
- Fax
- (520) 624-5464
- NPI assigned
- May 25, 2012
- Last updated
- May 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-13083 | AZ | Primary |
Addresses
Primary practice location
240 N Court Ave
Tucson, AZ 85701
Mailing address
PO Box 85400
Tucson, AZ 85754-5400
Phone (520) 904-5113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-13083 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526601600000",
"number": "1750641569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 85400",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857545400",
"telephone_number": "520-904-5113",
"fax_number": "520-624-5464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 N COURT AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85701",
"telephone_number": "520-904-5113",
"fax_number": "520-624-5464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDENER",
"first_name": "CHRISTINE",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-25",
"last_updated": "2018-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW-13083",
"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 May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.