Active NPI
Clarence Aaron Enos, LCMSW
- Clinical Social Worker
- Gallup, NM
National Provider Identifier
1306279559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- X-10430
- Practice address
- 216 W Maloney Ave
Gallup, NM 87301-5214 - Phone
- (505) 870-1483
- NPI assigned
- Aug 12, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | M-07770 | NM | |
| Clinical Social Worker | 1041C0700X | X-10430 | NM | Primary |
Addresses
Primary practice location
216 W Maloney Ave
Gallup, NM 87301-5214
Mailing address
PO Box 3809
Gallup, NM 87305-3809
Phone (505) 863-3377
Other practice location 1
211 W Mesa Ave Ste 4
Gallup, NM 87301-6392
Phone (505) 879-3608
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 |
|---|---|---|---|
| M-07770 | NM | MD | Social Worker |
| X-10430 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hozho Center for Personal Enhancement | Social Worker | 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.
-
- Community/Behavioral Health Agency
- Gallup, NM
- NPI 1285088963
Social Worker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523577600000",
"number": "1306279559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3809",
"city": "GALLUP",
"state": "NM",
"postal_code": "873053809",
"telephone_number": "505-863-3377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W MALONEY AVE",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015214",
"telephone_number": "505-870-1483"
}
],
"practiceLocations": [
{
"address_1": "211 W Mesa Ave Ste 4",
"address_purpose": "LOCATION",
"city": "Gallup",
"state": "NM",
"postal_code": "873016392",
"country_code": "US",
"telephone_number": "505-879-3608",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ENOS",
"first_name": "CLARENCE",
"middle_name": "AARON",
"credential": "LCMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-12",
"last_updated": "2018-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-07770",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "X-10430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.