Individual provider Active NPI

Juanita Raquel Zengerle, LISW

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1184940231
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-08136 Issued in NM
Practice address
2960 Rodeo Park Dr W
Santa Fe, NM 87505-6351
Phone
(505) 660-5364
Fax
(505) 474-4663
NPI assigned
Apr 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X X-06738 NM
Clinical Social Worker 1041C0700X I-08136 NM Primary

Addresses

Primary practice location

2960 Rodeo Park Dr W
Santa Fe, NM 87505-6351

Mailing address

2960 Rodeo Park Dr W
Santa Fe, NM 87505-6351
Phone (505) 660-5364

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-08136NMMDClinical Social Worker
X-06738NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1184940231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 RODEO PARK DR W",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056351",
            "telephone_number": "505-660-5364",
            "fax_number": "505-474-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 RODEO PARK DR W",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056351",
            "telephone_number": "505-660-5364",
            "fax_number": "505-474-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENGERLE",
        "first_name": "JUANITA",
        "middle_name": "RAQUEL",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "X-06738",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-08136",
            "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 Jan 27, 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.

Verify at the official NPI Registry.