Active NPI
Monique Sisson
- Social Worker
- Santa Fe, NM
National Provider Identifier
1104658210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SWB-2024-0895
- Practice address
- 2055 S Pacheco St Ste 500
Santa Fe, NM 87505-3994 - Phone
- (505) 702-8112
- Fax
- (505) 355-2611
- NPI assigned
- Aug 16, 2024
- 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 | SWB-2024-0895 | NM | Primary |
Addresses
Primary practice location
2055 S Pacheco St Ste 500
Santa Fe, NM 87505-3994
Mailing address
2055 S Pacheco St Ste 500
Santa Fe, NM 87505-3994
Phone (505) 702-8112
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWB-2024-0895 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trail Ahead Therapy, LLC | Social Worker | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Albuquerque, NM
- NPI 1235733437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1104658210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 S PACHECO ST STE 500",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875053994",
"telephone_number": "505-702-8112",
"fax_number": "505-355-2611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 S PACHECO ST STE 500",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875053994",
"telephone_number": "505-702-8112",
"fax_number": "505-355-2611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISSON",
"first_name": "MONIQUE",
"sole_proprietor": "NO",
"sex": "U",
"enumeration_date": "2024-08-16",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "SWB-2024-0895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.