Individual provider Active NPI

Taylor Joanne Faver, LCSW

  • Clinical Social Worker
  • Portales, NM
National Provider Identifier
1043872815
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2022-0801 Issued in NM
Practice address
501 S Abilene Ave
Portales, NM 88130-6380
Phone
(575) 356-7000
NPI assigned
Jul 2, 2019
Last updated
Jan 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-10980 NM
Social Worker 104100000X B-10661 NM
Social Worker 104100000X SWB-2022-0801 NM
Clinical Social Worker 1041C0700X SWB-2022-0801 NM Primary

Addresses

Primary practice location

501 S Abilene Ave
Portales, NM 88130-6380

Mailing address

343 S Roosevelt Road R
Portales, NM 88130-9011
Phone (575) 607-5590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513003078 NM Practitioner - Clinical Social Worker 9133560865 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B-10661NMMDSocial Worker
M-10980NMMDSocial Worker
SWB-2022-0801NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Counseling, LLC Clinical CurrentSince May 3, 2024 Accepting new patients
Clovis Municipal Schools Past Accepting new patients
Portales Municipal Schools PastSince Jan 19, 2025 Accepting new patients

Organizations & group practices 3

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1043872815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 S ROOSEVELT ROAD R",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881309011",
            "telephone_number": "575-607-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S ABILENE AVE",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306380",
            "telephone_number": "575-356-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVER",
        "first_name": "TAYLOR",
        "middle_name": "JOANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-10980",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "B-10661",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "SWB-2022-0801",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-0801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portales, NM

Sources for this page

Verify at the official NPI Registry.