Individual provider Active NPI

Angela D. Oliver, LCSW

  • Clinical Social Worker
  • El Prado, NM
National Provider Identifier
1003008202
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-06235 Issued in NM
Practice address
244 Tune Drive
El Prado, NM 87529
Phone
(575) 751-9858
Fax
(575) 751-9858
NPI assigned
Aug 13, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I-06235 NM
Clinical Social Worker 1041C0700X C-06235 NM Primary

Addresses

Primary practice location

244 Tune Drive
El Prado, NM 87529

Mailing address

PO Box 278
El Prado, NM 87529-0278
Phone (575) 751-9858

Other practice location 1

320 Paseo Del Pueblo Sur Ste B
Taos, NM 87571-5021
Phone (575) 613-6789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-06235NMMDMental Health Counselor
C-06235NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sangre de Cristo Community Health Partnership Mental Health Past Accepting new patients
Nonviolence Works, Inc. PastSince Mar 2, 2018 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003008202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "EL PRADO",
            "state": "NM",
            "postal_code": "875290278",
            "telephone_number": "575-751-9858",
            "fax_number": "575-613-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 TUNE DRIVE",
            "city": "EL PRADO",
            "state": "NM",
            "postal_code": "87529",
            "telephone_number": "575-751-9858",
            "fax_number": "575-751-9858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Paseo Del Pueblo Sur Ste B",
            "address_purpose": "LOCATION",
            "city": "Taos",
            "state": "NM",
            "postal_code": "875715021",
            "country_code": "US",
            "telephone_number": "575-613-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "ANGELA",
        "middle_name": "D.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "I-06235",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-06235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Prado, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.