Active NPI
Clarissa Renee Otero, MASTER SOCIAL WORKER
- School Social Worker
- Dexter, NM
National Provider Identifier
1275628117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- B4287
- Practice address
- 100 E Monrill
Dexter, NM 88230 - Phone
- (505) 734-5420
- Fax
- (505) 734-6813
- NPI assigned
- Oct 4, 2006
- Last updated
- Jul 8, 2007
- 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 | B4287 | NM | Primary |
Addresses
Primary practice location
100 E Monrill
Dexter, NM 88230
Mailing address
306 N Kansas Ave
Roswell, NM 88201
Phone (505) 623-3702
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 |
|---|---|---|---|
| B4287 | NM | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275628117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 N KANSAS AVE",
"city": "ROSWELL",
"state": "NM",
"postal_code": "88201",
"telephone_number": "505-623-3702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E MONRILL",
"city": "DEXTER",
"state": "NM",
"postal_code": "88230",
"telephone_number": "505-734-5420",
"fax_number": "505-734-6813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTERO",
"first_name": "CLARISSA",
"middle_name": "RENEE",
"name_prefix": "Ms.",
"credential": "MASTER SOCIAL WORKER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NM",
"license": "B4287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dexter, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.