Active NPI
Letha Sue Olmos, LISW
- Social Worker
- Albuquerque, NM
National Provider Identifier
1215129143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I-07273
- Practice address
- 540 Chama St. NE
Albuquerque, NM 87108 - Phone
- (505) 265-0753
- Fax
- (505) 268-5722
- NPI assigned
- Aug 14, 2007
- Last updated
- Oct 22, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | X-05627 | NM | |
| Social Worker | 104100000X | I-07273 | NM | Primary |
Addresses
Primary practice location
540 Chama St. NE
Albuquerque, NM 87108
Mailing address
540 Chama St NE
Albuquerque, NM 87108
Phone (505) 265-0753
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36628271 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| X-05627 | NM | MD | Mental Health Counselor |
| I-07273 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1215129143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 CHAMA ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87108",
"telephone_number": "505-265-0753",
"fax_number": "505-268-5722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 CHAMA ST. NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87108",
"telephone_number": "505-265-0753",
"fax_number": "505-268-5722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLMOS",
"first_name": "LETHA",
"middle_name": "SUE",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-14",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "X-05627",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "I-07273",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36628271",
"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 Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.