Individual provider Active NPI

Gina Lorraine Deluca, LCSW

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1114279601
Registry record updated Oct 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-09792 Issued in NM
Practice address
2960 Rodeo Park Dr W
Santa Fe, NM 87505-6351
Phone
(505) 986-9633
NPI assigned
Oct 8, 2012
Last updated
Oct 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C-09792 NM
Clinical Social Worker 1041C0700X C-09792 NM Primary

Addresses

Primary practice location

2960 Rodeo Park Dr W
Santa Fe, NM 87505-6351

Mailing address

2960 Rodeo Park Dr W
Santa Fe, NM 87505-6351
Phone (505) 986-9633

Other practice location 1

404 Hunter St
Espanola, NM 87532-2655
Phone (505) 753-4123

Other identifiers 1

IdentifierTypeStateIssuer
E7436MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20171103000394 NM Practitioner - Clinical Social Worker 0244596435 Reassigns benefits to 2 organizations
Practice locations: Santa Fe, NM

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-09792NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy & Pastoral Counseling Associates CurrentSince Jan 1, 2021 Accepting new patients
Peace for Joy Counseling LLC Clinical CurrentSince Aug 10, 2024 Accepting new patients
Las Cumbres Community Services Past Accepting new patients
Las Cumbres Community Services Past Accepting new patients

Locations

2019 Galisteo St
Ste M1A
Santa Fe, NM 87505
Phone (505) 988-4131

Organizations & group practices 4

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": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696118400000",
    "number": "1114279601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 RODEO PARK DR W",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056351",
            "telephone_number": "505-986-9633",
            "fax_number": "505-473-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 RODEO PARK DR W",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056351",
            "telephone_number": "505-986-9633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 Hunter St",
            "address_purpose": "LOCATION",
            "city": "Espanola",
            "state": "NM",
            "postal_code": "875322655",
            "country_code": "US",
            "telephone_number": "505-753-4123",
            "fax_number": "505-753-6947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELUCA",
        "first_name": "GINA",
        "middle_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2023-10-01",
        "certification_date": "2023-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": "C-09792",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E7436",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.