Active NPI
Glenda Mazon, LMSW
- Social Worker
- Santa Fe, NM
National Provider Identifier
1164829180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- M-04977
- Practice address
- 13 East Old Agua Fria Road
Santa Fe, NM 87508-5970 - Phone
- (505) 988-1169
- Fax
- (505) 982-4053
- NPI assigned
- Nov 20, 2014
- Last updated
- Nov 20, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M-04977 | NM | Primary |
Addresses
Primary practice location
13 East Old Agua Fria Road
Santa Fe, NM 87508-5970
Mailing address
13 East Old Agua Fria Road
Santa Fe, NM 87508-5970
Phone (505) 988-1169
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 |
|---|---|---|---|
| M-04977 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1164829180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 EAST OLD AGUA FRIA ROAD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875085970",
"telephone_number": "505-988-1169",
"fax_number": "505-982-4053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 EAST OLD AGUA FRIA ROAD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875085970",
"telephone_number": "505-988-1169",
"fax_number": "505-982-4053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZON",
"first_name": "GLENDA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-20",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-04977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.