Leasette Marie Hernandez, LMSW
Individual provider Active NPI Clinical Social Worker · Chaparral, NM
NPI 1144768417 · NPPES record last updated Aug 30, 2021
Key facts
- NPI
- 1144768417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C-11733 (NM)
- Practice address
- 510 E Lisa Dr
Chaparral, NM 88081 - Phone
- (575) 824-0820
- Fax
- (575) 824-1021
- NPI assigned
- Feb 7, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211004002465 | NM | Practitioner - Clinical Social Worker | 5698173706 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-10562 | NM | MD | Social Worker |
| X-10715 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transcending Counseling, LLC | Clinical | Current |
Accepting new patients |
Locations
210 W Las Cruces Ave
Ste A
Las Cruces, NM 88005
210 W Las Cruces Ave
Las Cruces, NM 88005
Phone (575) 249-0390
Interoperability endpoints
- leasette.hernandez@lcdfnm.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-11733 | NM | Yes |
| Social Worker | 104100000X | X-10715 | NM | |
| Social Worker | 104100000X | M-10562 | NM |
Addresses
Primary practice location
510 E Lisa Dr
Chaparral, NM 88081
Mailing address
385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105
Other practice location 1
110 N I35
Ste 315 #153
Round Rock, TX 78681
Phone (512) 761-5166
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91656556 | Medicaid | NM |
Other names
- Leasette Marie Conway
Other providers in Chaparral, NM
- Veronica Gonzalez
- Gustavo Gutierrez
- Healthnet Medical Family & Internal Medicine LLC
- Carlos Roberto Hernandez
- Jesus Hernandez
- Monica Hernandez
- Rigoberto Hernandez
- Victoria Herrera
- Kellie Hoskins
- Mahmood R Hurab
All providers in Chaparral, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.