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NPI Code Detail

MEDICARE: DHHS-PHS, IHS TUCSON AREA, IHS TUCSON SAN XAVIER CLINIC

MEDICARE: DHHS-PHS, IHS TUCSON AREA, IHS TUCSON SAN XAVIER CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2104100000XSocial Worker
31041S0200XSchool Social Worker
4103TA0400XAddiction (Substance Use Disorder) Psychologist
5101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11437157302OTHERAZFACILITY NPI #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3AZ0929620OTHERAZBC/BS OF AZ PROV #
40325678OTHERAZNACADP #
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043273006
Entity Type Code : Organization
Provider Name (Legal Business Name) : DHHS-PHS, IHS TUCSON AREA, IHS TUCSON SAN XAVIER CLINIC
Provider Business Mailing Address
First Line : 7900 S J STOCK RD
Second Line :
City : TUCSON
State : AZ
Zip : 85746-7012
Country : US
Telephone Number : 520-295-2427
Fax Number : 520-295-2611
Provider Business Practice Location Address
First Line : 7900 S J STOCK RD
Second Line :
City : TUCSON
State : AZ
Zip : 85746-7012
Country : US
Telephone Number : 520-295-2427
Fax Number : 520-295-2611
Authorized Official
Title or Position : ACCOUNTING AND BUDGET OFFICER
Name : MR. KURT PRIESSMAN
Credential : B.A., M.B.A., C.P.M.
Telephone Number : 520-295-2427
Provider Enumeration Date : 04/10/2006
Last Update Date : 09/11/2025

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Practice Fax: 520-295-2611

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