NPIMap

Individual provider Active NPI

Jessica Benavidez, LMSW

  • Social Worker
  • Las Vegas, NM
National Provider Identifier
1104422302
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M-11870
Practice address
1235 8TH St
Las Vegas, NM 87701-4219
Phone
(505) 425-6788
Fax
(505) 747-7396
NPI assigned
Dec 11, 2020
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-11870 Primary
Mental Health Counselor 101YM0800X X-11743 NM

Addresses

Primary practice location

1235 8TH St
Las Vegas, NM 87701-4219

Mailing address

PO Box 158
Espanola, NM 87532-0158
Phone (505) 753-7218

Other names 1

  • Jessica Montano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients

Organizations & group practices 10

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": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1104422302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875320158",
            "telephone_number": "505-753-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 8TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014219",
            "telephone_number": "505-425-6788",
            "fax_number": "505-747-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDEZ",
        "first_name": "JESSICA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "M-11870",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "X-11743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MONTANO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.