Individual provider Active NPI

Deborah Kirk Elder, MSW, ACSW, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1902886633
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW0558 Issued in AZ
Practice address
2200 E River Rd
Suite 121
Tucson, AZ 85718-6514
Phone
(520) 577-3652
Fax
(520) 577-3516
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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 LCSW0558 AZ Primary

Addresses

Primary practice location

2200 E River Rd
Suite 121
Tucson, AZ 85718-6514

Mailing address

2200 E River Rd
Suite 121
Tucson, AZ 85718-6514
Phone (520) 577-3652

Other identifiers 1

IdentifierTypeStateIssuer
799322MedicaidAZ

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
I20051115000999 AZ Practitioner - Clinical Social Worker 1557380995 Practice locations: Tucson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2200 E River Rd
Suite 107
Tucson, AZ 85718-6516
Phone (520) 577-3652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW0558AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catalina Foothills Pediatric Psychiatry Past Accepting new patients
Inner Journey Psychological Services, LLC PastSince Oct 26, 2005 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1902886633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E RIVER RD",
            "address_2": "SUITE 121",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186514",
            "telephone_number": "520-577-3652",
            "fax_number": "520-577-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E RIVER RD",
            "address_2": "SUITE 121",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186514",
            "telephone_number": "520-577-3652",
            "fax_number": "520-577-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK ELDER",
        "first_name": "DEBORAH",
        "credential": "MSW, ACSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW0558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "799322",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.