Misty Renee Sturtevant, , LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-12121 Issued in NM

Practice address

110 E Mescalero Rd
Roswell, NM 88201-6542

Phone

(575) 755-2275

Fax

(575) 622-3325

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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.

• La Casa de Buena Salud Inc.

  • Federally Qualified Health Center (FQHC)
  • Portales, NM
  • NPI 1972603165
  Medicare reassignment NPD
• La Casa de Buena Salud Inc

  • Federally Qualified Health Center (FQHC)
  • Clovis, NM
  • NPI 1760788137
  NPD
• Revive Therapy and Wellness LLC

  • Clinical Social Worker
  • Belvidere, IL
  • NPI 1780446476
  NPD (past)

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1255985693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E MESCALERO RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016542",
            "telephone_number": "575-755-2275",
            "fax_number": "575-622-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MESCALERO RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016542",
            "telephone_number": "575-755-2275",
            "fax_number": "575-622-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURTEVANT",
        "first_name": "MISTY",
        "middle_name": "RENEE",
        "credential": ", LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-12121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally D Stewart, LMSW
• Luke Stiggins
• Gabriele Stiller, MD
• Haley Michelle Stotts
• Reba Stroble
• Ramya Subgani, DDS
• Adalberto Subia-Juarez
• Stephanie Sugg
• Sun Country Physical Therapy
• Sunset Villa Healthcare LLC

• Clinical Social Worker in Roswell, NM
• Providers in Roswell, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.