Provider Demographics
NPI:1053513481
Name:COOMBES, ROY R (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROY
Middle Name:R
Last Name:COOMBES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 E BROADWAY BLVD
Mailing Address - Street 2:#215
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5301
Mailing Address - Country:US
Mailing Address - Phone:520-850-1164
Mailing Address - Fax:
Practice Address - Street 1:2919 E BROADWAY BLVD
Practice Address - Street 2:#215
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-5301
Practice Address - Country:US
Practice Address - Phone:520-850-1164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 3880I1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical