Individual provider Active NPI

Dana P Ruvalcaba, LCSW, ACSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1871636456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-2745 Issued in AZ
Practice address
9030 E Bear Creek Dr
Tucson, AZ 85749-9642
Phone
(520) 490-2144
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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-2745 AZ Primary

Addresses

Primary practice location

9030 E Bear Creek Dr
Tucson, AZ 85749-9642

Mailing address

9030 E Bear Creek Dr
Tucson, AZ 85749-9642
Phone (520) 490-2144

Other names 1

  • Dana P Berardi Former name

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
I20130510000331 AZ Practitioner - Clinical Social Worker 8123265196 Practice locations: Tucson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2037 N Beverly Ave
Tucson, AZ 85712-3605
Phone (520) 318-9276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
LCSW-2745AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871636456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 E BEAR CREEK DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857499642",
            "telephone_number": "520-490-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 E BEAR CREEK DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857499642",
            "telephone_number": "520-490-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUVALCABA",
        "first_name": "DANA",
        "middle_name": "P",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-2745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "BERARDI",
            "middle_name": "P",
            "credential": "LCSW, ACSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.