Individual provider Active NPI

Dawn E Tubbs, SW, LPC

  • Social Worker
  • Eau Claire, WI
National Provider Identifier
1770927162
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
9749-120 Issued in WI
Practice address
505 S Dewey St
Suite 101
Eau Claire, WI 54701-3704
Phone
(715) 836-0064
Fax
(715) 836-0065
NPI assigned
Apr 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1658-226 WI
Social Worker 104100000X 9749-120 WI Primary

Addresses

Primary practice location

505 S Dewey St
Suite 101
Eau Claire, WI 54701-3704

Mailing address

3531 Sundet Rd
Eau Claire, WI 54703-0355
Phone (715) 836-0064

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
1658-226WIMDProfessional Counselor
9749-120WIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1770927162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 SUNDET RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547030355",
            "telephone_number": "715-836-0064",
            "fax_number": "715-836-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S DEWEY ST",
            "address_2": "SUITE 101",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547013704",
            "telephone_number": "715-836-0064",
            "fax_number": "715-836-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "DAWN",
        "middle_name": "E",
        "credential": "SW, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1658-226",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "9749-120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.