Individual provider Active NPI

William Smith Brubaker Sr., LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1780069047
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-2457 Issued in AZ
Practice address
3295 W Ina Rd Ste 125
Tucson, AZ 85741-2195
Phone
(520) 257-1168
Fax
(520) 306-4861
NPI assigned
Jul 28, 2015
Last updated
Sep 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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-2457 AZ Primary

Addresses

Primary practice location

3295 W Ina Rd Ste 125
Tucson, AZ 85741-2195

Mailing address

1500 N Wilmot Rd Ste A200
Tucson, AZ 85712-4416
Phone (520) 873-8562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-2457AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Psychiatry PLLC CurrentSince May 26, 2024 Accepting new patients
Affinity Counseling Center LLC Past Accepting new patients

Locations

1500 N Wilmot Rd
Ste A200
Tucson, AZ 85712
Phone (520) 873-8562

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1780069047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N WILMOT RD STE A200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124416",
            "telephone_number": "520-873-8562",
            "fax_number": "888-851-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 W INA RD STE 125",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412195",
            "telephone_number": "520-257-1168",
            "fax_number": "520-306-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "WILLIAM",
        "middle_name": "SMITH",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-2457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.