Jennifer Maree Stanley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-09369 Issued in NM

Practice address

120 Aliso Dr SE
Albuquerque, NM 87108-2693

Phone

(505) 629-5374

NPI assigned

Dec 18, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New Moon Therapy, LLC

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1912607235
  NPD Authorized official
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Wagon Mound, NM
  • NPI 1538324223
  NPD (past)
• The Life Link

  • Community/Behavioral Health Agency
  • Santa Fe, NM
  • NPI 1841332400
  NPD (past)

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

{
    "created_epoch": "1292630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679788800000",
    "number": "1073816773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871199222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ALISO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082693",
            "telephone_number": "505-629-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "JENNIFER",
        "middle_name": "MAREE",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-18",
        "last_updated": "2023-03-26",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "1073816773",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tania Stanford
• Debra Stanger, R.N.
• Abigail Leah Stanislaw, DPT
• Blake R Staniszewski, LCSW
• Angelica Stanley
• Pamela J. Stanley, LPCC, ACT
• Tayler Nicole Stanley
• Daniel Stansbery, FNP-C
• Terry Stanton Jr., M.D.
• Dominic Stape, DOM

• 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 Mar 26, 2023; 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.