Timothy W Watkins, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

M-07371 Issued in NM

Practice address

18 Eagle St
Santo Domingo Pueblo, NM 87052-8705

Phone

(505) 465-2733

NPI assigned

Sep 24, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Santa Fe Supportive Therapy, LLC

  • Clinical Social Worker
  • Santa Fe, NM
  • NPI 1043502388
  Medicare reassignment NPD
• Ride to Pride Partnership, Inc.

  • Community/Behavioral Health Agency
  • Las Vegas, NM
  • NPI 1356756845
  NPD (past)
• Santo Domingo Behavioral Health

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1134248909
  NPD (past)
• Santo Domingo Pueblo

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1396944211
  NPD (past)

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1194033100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870520130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 EAGLE ST",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870528705",
            "telephone_number": "505-465-2733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Alameda Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NM",
            "postal_code": "877013996",
            "country_code": "US",
            "telephone_number": "505-454-9738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-07371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B8961",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Aime Strimpel, RN
• Dezbah Stumpff, LMHC
• Crystal J Tortalita
• Soren Uhl, RN
• Janet Reyes Vega, RN
• Yu Jin Williams, RN
• Johannah Renee Yazzie, CPNP-PC
• Kaitlyn Yepa, RN

• Social Worker in Santo Domingo Pueblo, NM
• Providers in Santo Domingo Pueblo, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.