Jeanette Olivia Antunez, LISW (CSW), LPN

Primary specialty

Social WorkerTaxonomy code 104100000X

License

C-2702 Issued in NM

Practice address

1025 Hermosa Dr SE
Albuquerque, NM 87108-4312

Phone

(505) 237-0061

NPI assigned

Apr 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jeanette O Lucero Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1306342787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 QUARTERHORSE LN NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203011",
            "telephone_number": "505-899-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 HERMOSA DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084312",
            "telephone_number": "505-237-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUNEZ",
        "first_name": "JEANETTE",
        "middle_name": "OLIVIA",
        "credential": "LISW (CSW),  LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": "C-2702",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "C-2702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTE",
            "last_name": "LUCERO",
            "middle_name": "O",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.

Verify at the official NPI Registry.