Jack L. Humphries, Lisw, LTD.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-3613 Issued in NM

Legal business name

JACK L. HUMPHRIES, LISW, LTD.

Practice address

8800 Palomar Ave NE
Albuquerque, NM 87109-7205

Phone

(505) 620-5225

Fax

(505) 798-1743

NPI assigned

Dec 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jack L. Humphries, LISW

Title

President

Phone

(505) 620-5225

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043376288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16387",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871916387",
            "telephone_number": "505-620-5225",
            "fax_number": "505-798-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 PALOMAR AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871097205",
            "telephone_number": "505-620-5225",
            "fax_number": "505-798-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK L. HUMPHRIES, LISW, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUMPHRIES",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-620-5225",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-3613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24500721",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37982788",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D-4525",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NM60084",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Jabar, LISW
• Reem Jaber
• Debra Joy Jaccard, PMHNP-BC
• Melinda Jachin, PA-C
• Iris Jacinto, LISW
• Bruce Alexander Jack, RPH
• Eric Jack
• Jocelyn Marie Jackman, NNP
• Lily A Jackman, RN
• Roseann Jacks, RN

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.