Active NPI
Kathryn Rebecca Fortune-Gallagher, LMSW, ACSW
- Clinical Social Worker
- Las Cruces, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SWB-2025-0561.
- Practice address
- 2623 Blue Heron PL
Las Cruces, NM 88011-4392 - Phone
- (734) 260-3777
- Fax
- (999) 999-9999
- NPI assigned
- Aug 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 097803-01 | NY | |
| Clinical Social Worker | 1041C0700X | SWB-2025-0561. | NM | Primary |
| Social Worker | 104100000X | 6801067347 | MI |
Addresses
Primary practice location
2623 Blue Heron PL
Las Cruces, NM 88011-4392
Mailing address
2623 Blue Heron PL
Las Cruces, NM 88011-4392
Phone (734) 260-3777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, NM, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1992
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
500 Westover Dr
Sanford, NC 27330-8941
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWB-2025-0561. | NM | MD | Clinical Social Worker |
| 097803-01 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
| Mental Health Specialty Group PA | Current | Accepting new patients | |
| Shine Medical Providers PC | Past | Accepting new patients | |
| Uplift Behavioral Health PC | Clinical | Past | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616
500 Marquette Ave NW
Ste 1200
Albuquerque, NM 87102
Phone (505) 295-6685
500 Marquette Ave NW
Albuquerque, NM 87102
Phone (505) 429-5750
165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964
Organizations & group practices 4
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.
-
- Psychiatry Physician
- Philadelphia, PA
- NPI 1538894050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767830400000",
"number": "1285914119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2623 BLUE HERON PL",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880114392",
"telephone_number": "734-260-3777",
"fax_number": "999-999-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2623 BLUE HERON PL",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880114392",
"telephone_number": "734-260-3777",
"fax_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNE-GALLAGHER",
"first_name": "KATHRYN",
"middle_name": "REBECCA",
"credential": "LMSW, ACSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-23",
"last_updated": "2026-01-08",
"certification_date": "2026-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "097803-01",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "SWB-2025-0561.",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801067347",
"primary": false
}
],
"identifiers": [],
"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 Jan 8, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.