Bertha De Vries

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-09224 Issued in NM

Practice address

201 Cedar St SE Ste 820
Albuquerque, NM 87106-4912

Phone

(505) 841-1434

Fax

(505) 222-2149

NPI assigned

Nov 14, 2016

Last updated

Nov 14, 2016By 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)

Enrolled

State licenses

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1114469756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE STE 820",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064912",
            "telephone_number": "505-841-1434",
            "fax_number": "505-222-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VRIES",
        "first_name": "BERTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth De Pirro, M.D.
• Ruth G De Rego, CNP
• Natalie De Santiago, LMSW
• Nunzio Paul De Santis, BSPHARM
• Allen J De Somer, RPH
• Robert E Deacon, MA, LPCC
• Nicole Deam, RN
• Dean Eyecare, PC (New Mexico Eyecare)
• Allen Dean, DDS
• Amanda B Dean, LMSW

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, 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 Nov 14, 2016; 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.