Individual provider Active NPI

Kathryn J. Schmidt, LCSW

  • Clinical Social Worker
  • Las Cruces, NM
National Provider Identifier
1205390580
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-11566 Issued in NM
Practice address
535 S. Miranda St.
Las Cruces, NM 88005
Phone
(575) 647-2800
Fax
(575) 647-2898
NPI assigned
Jan 30, 2019
Last updated
Jul 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-09839 NM
Social Worker 104100000X 66160 TX
Clinical Social Worker 1041C0700X 66160 TX
Clinical Social Worker 1041C0700X C-11566 NM Primary

Addresses

Primary practice location

535 S. Miranda St.
Las Cruces, NM 88005

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Other practice location 1

100 W Griggs Ave
Las Cruces, NM 88001
Phone (575) 647-2800

Other practice location 2

2714 Wyoming Ave
El Paso, TX 79903-3928
Phone (915) 263-4623

Other identifiers 1

IdentifierTypeStateIssuer
73233862MedicaidNM

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
66160TXMDProfessional Counselor
M-09839NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Borderland Rainbow Center Social Worker Current Accepting new patients

Locations

2714 Wyoming Ave
El Paso, TX 79903
Phone (915) 262-4623

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1205390580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S. MIRANDA ST.",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88005",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W Griggs Ave",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "88001",
            "country_code": "US",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2714 Wyoming Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799033928",
            "country_code": "US",
            "telephone_number": "915-263-4623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "KATHRYN",
        "middle_name": "J.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-09839",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "66160",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66160",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73233862",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; 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.