Active NPI
Kendra S Elliott, LBSW
- School Social Worker
- Clovis, NM
National Provider Identifier
1255085155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- X-12292
- Practice address
- 1600 Sutter PL
Clovis, NM 88101-4611 - Phone
- (575) 769-4490
- Fax
- (575) 769-4330
- NPI assigned
- Feb 9, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | X-12292 | NM | Primary |
Addresses
Primary practice location
1600 Sutter PL
Clovis, NM 88101-4611
Mailing address
PO Box 19000
Clovis, NM 88102-9000
Phone (575) 769-4490
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
| License | State | Type | Specialty |
|---|---|---|---|
| X-12292 | NM | MD | School Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clovis Municipal Schools | Past | 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.
-
- Local Education Agency (LEA)
- Clovis, NM
- NPI 1174662316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1255085155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19000",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881029000",
"telephone_number": "575-769-4490",
"fax_number": "575-769-4330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SUTTER PL",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881014611",
"telephone_number": "575-769-4490",
"fax_number": "575-769-4330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "KENDRA",
"middle_name": "S",
"credential": "LBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-09",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NM",
"license": "X-12292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.