Active NPI
Annette Mirabal
- Social Worker
- Las Cruces, NM
National Provider Identifier
1053780023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- C-08639
- Practice address
- 151 S Walnut St
Suite C-6
Las Cruces, NM 88001-2617 - Phone
- (575) 527-5770
- Fax
- (575) 532-1928
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | C-08639 | NM | Primary |
Addresses
Primary practice location
151 S Walnut St
Suite C-6
Las Cruces, NM 88001-2617
Mailing address
151 S Walnut St
Suite C-6
Las Cruces, NM 88001-2605
Phone (575) 527-5770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C-08639 | Other | NM | NM LCSW LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
125 W Boutz Rd
Las Cruces, NM 88005-3118
Phone (575) 523-5222
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 4 Directions Integrative Mental Health, LLC | Current | Accepting new patients | |
| Darlin Inc Dba Horizon Services | Social Worker | Past | Accepting new patients |
| Darlin Inc., Dba Horizon Services | Past | Accepting new patients |
Locations
125 W Boutz Rd
Las Cruces, NM 88005
Phone (575) 523-5222
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Las Cruces, NM
- NPI 1013559038
-
- Professional Counselor
- Las Cruces, NM
- NPI 1235589359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442793600000",
"number": "1053780023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 S WALNUT ST",
"address_2": "SUITE C-6",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880012605",
"telephone_number": "575-527-5770",
"fax_number": "575-532-1928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 S WALNUT ST",
"address_2": "SUITE C-6",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880012617",
"telephone_number": "575-527-5770",
"fax_number": "575-532-1928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRABAL",
"first_name": "ANNETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2015-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "C-08639",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NM LCSW LICENSE",
"identifier": "C-08639",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.