Provider Demographics
NPI:1700013109
Name:TOMPKINS, JOAN (MSW, LCSW, MAC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:MSW, LCSW, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SHELTON MCMURPHEY BLVD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4928
Mailing Address - Country:US
Mailing Address - Phone:541-485-2711
Mailing Address - Fax:888-975-0250
Practice Address - Street 1:1200 HILYARD ST STE 450
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8164
Practice Address - Country:US
Practice Address - Phone:458-205-7131
Practice Address - Fax:458-205-7061
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL5791101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500720360Medicaid
OR500662986Medicaid