Jessica Monique Lucero, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C11944 Issued in NM

Practice address

3 Mora Valley Clinic Rd
Mora, NM 87732-2202

Phone

(575) 387-5069

Fax

(575) 387-9006

NPI assigned

Jan 3, 2022

Last updated

Jan 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1083375091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "MORA",
            "state": "NM",
            "postal_code": "877320209",
            "telephone_number": "575-387-5069",
            "fax_number": "575-387-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MORA VALLEY CLINIC RD",
            "city": "MORA",
            "state": "NM",
            "postal_code": "877322202",
            "telephone_number": "575-387-5069",
            "fax_number": "575-387-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "JESSICA",
        "middle_name": "MONIQUE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C11944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael J. Lee, PA-C
• Jessica Rose Martinez, FNP-BC
• Tyler E Martinez, DDS
• Mora Independent School
• Mora Valley Community Health Services
• Mora Valley Community Health Services Inc

• Clinical Social Worker in Mora, NM
• Providers in Mora, 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 Jan 3, 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.