Active NPI
Samantha Baca
- Clinical Social Worker
- Taos, NM
National Provider Identifier
1134847973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SWB-2023-0172
- Practice address
- 105 Bertha Rd Ste B
Taos, NM 87571-7148 - Phone
- (575) 758-4297
- NPI assigned
- Aug 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SWB-2023-0172 | NM | Primary |
| Peer Specialist | 175T00000X |
Addresses
Primary practice location
105 Bertha Rd Ste B
Taos, NM 87571-7148
Mailing address
207 E Mesa Ave
Gallup, NM 87301-6145
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-2023-0172 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1134847973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 E MESA AVE",
"city": "GALLUP",
"state": "NM",
"postal_code": "873016145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 BERTHA RD STE B",
"city": "TAOS",
"state": "NM",
"postal_code": "875717148",
"telephone_number": "575-758-4297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACA",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-18",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "SWB-2023-0172",
"primary": true
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.