Individual provider Active NPI

Melissa Marquez, LCSW

  • Clinical Social Worker
  • Alamosa, CO
National Provider Identifier
1104335058
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926675 Issued in CO
Practice address
8745 County Road 9 S
Alamosa, CO 81101-9610
Phone
(719) 589-3671
NPI assigned
Sep 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X CSW.09926675 CO Primary

Addresses

Primary practice location

8745 County Road 9 S
Alamosa, CO 81101-9610

Mailing address

8745 County Road 9 S
Alamosa, CO 81101-9610
Phone (719) 589-3671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20200724001903 CO Practitioner - Clinical Social Worker 5092139998 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Valley Community Mental Health Center, Inc. Current Accepting new patients
San Luis Valley Community Mental Health Center, Inc. CurrentSince May 20, 2020 Accepting new patients
San Luis Valley Community Mental Health Center Mental Health CurrentSince May 20, 2020 Accepting new patients

Locations

8745 County Road 9 S
Alamosa, CO 81101
Phone (719) 587-5612

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.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104335058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8745 COUNTY ROAD 9 S",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811019610",
            "telephone_number": "719-589-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 COUNTY ROAD 9 S",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811019610",
            "telephone_number": "719-589-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2022-07-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamosa, CO

Sources for this page

Verify at the official NPI Registry.