Individual provider Active NPI

Nicole Marie Padilla, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1194355974
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2024-0129 Issued in NM
Practice address
6330 Riverside Plaza LN NW Ste 260
Albuquerque, NM 87120-2160
Phone
(505) 226-2839
Fax
(505) 295-2559
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2024-0129 NM Primary

Addresses

Primary practice location

6330 Riverside Plaza LN NW Ste 260
Albuquerque, NM 87120-2160

Mailing address

652 Vista Lejos LN SW
Albuquerque, NM 87121-8980
Phone (505) 397-9034

Other practice location 1

652 Vista Lejos Ln SW
Albuquerque, NM 87121-8980
Phone (505) 804-8955

Other identifiers 1

IdentifierTypeStateIssuer
34183710MedicaidNM

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

LicenseStateTypeSpecialty
SWB-2024-0129NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cottonwood Counseling, LLC PastSince May 7, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1194355974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 VISTA LEJOS LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871218980",
            "telephone_number": "505-397-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 RIVERSIDE PLAZA LN NW STE 260",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202160",
            "telephone_number": "505-226-2839",
            "fax_number": "505-295-2559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "652 Vista Lejos Ln SW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871218980",
            "country_code": "US",
            "telephone_number": "505-804-8955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2024-0129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34183710",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.