Mark William Raybould, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-04965 Issued in NM

Practice address

2811 Indian School Rd NE
Albuquerque, NM 87106-1825

Phone

(505) 573-4044

Fax

(505) 573-4044

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mark W Raybould, Lisw, Inc

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1770762775

  NM

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1124095096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30811",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871900811",
            "telephone_number": "505-573-4044",
            "fax_number": "505-573-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 INDIAN SCHOOL RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871061825",
            "telephone_number": "505-573-4044",
            "fax_number": "505-573-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBOULD",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-04965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51681374",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ray
• Joie N Ray
• Laura Ray
• Marie Ray
• Anisa Rayan
• Marie D Rayburn, LSAA
• James Dean Rayl, RN MSN ACNP-BC CCRN
• Raymond G Murphy Veterans Health Administration
• Eleanor Raymond
• Helen Ann Raymond

• All providers in Albuquerque, NM
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.