Organization Active NPI

Xochihuan Traditional Healing and Psychotheraphy, LLC

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1124680319
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
XOCHIHUAN TRADITIONAL HEALING AND PSYCHOTHERAPHY, LLC
Practice address
1006 Jane St NE
Albuquerque, NM 87112-5612
Phone
(505) 485-3060
NPI assigned
Jul 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Authorized official

Name
Jaysa P Jones, LCSW
Title
Owner
Phone
(505) 450-6690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1006 Jane St NE
Albuquerque, NM 87112-5612

Mailing address

1006 Jane St NE
Albuquerque, NM 87112-5612
Phone (505) 485-3060

Other identifiers 1

IdentifierTypeStateIssuer
27174751MedicaidNM

National Provider Directory

National Provider Directory

Locations

3500 Comanche Rd NE
Ste E6
Albuquerque, NM 87107
Phone (505) 485-3060

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1124680319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 JANE ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125612",
            "telephone_number": "505-485-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 JANE ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125612",
            "telephone_number": "505-485-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XOCHIHUAN TRADITIONAL HEALING AND PSYCHOTHERAPHY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JAYSA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-450-6690",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27174751",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.