Individual provider Active NPI

Sherry Lynn Hatalsky, LCSW

  • Clinical Social Worker
  • Taos, NM
National Provider Identifier
1326109752
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-09194 Issued in NM
Practice address
417 Valverde Commons Dr
Taos, NM 87571-4475
Phone
(505) 585-1355
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 19238 CA
Clinical Social Worker 1041C0700X C-09194 NM Primary

Addresses

Primary practice location

417 Valverde Commons Dr
Taos, NM 87571-4475

Mailing address

417 Valverde Commons Dr
Taos, NM 87571-4475
Phone (505) 585-1355

Other practice location 1

3737 Sonoma Blvd
Vallejo, CA 94589-2201
Phone (707) 553-5814

Other practice location 2

2601 Wyoming Blvd NE Ste 203
Albuquerque, NM 87112-1033
Phone (505) 585-1355

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191213000567 NM Practitioner - Clinical Social Worker 4789017294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

417 Valverde Commons Dr
Taos, NM 87571-4475
Phone (575) 425-0906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 19238CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Many Paths Counseling Abq, LLC CurrentSince Aug 21, 2019 Accepting new patients

Locations

2601 Wyoming Blvd NE
Ste 203
Albuquerque, NM 87112
Phone (505) 585-1355

2601 Wyoming Blvd NE
Ste 200
Albuquerque, NM 87112
Phone (833) 585-8331

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326109752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 VALVERDE COMMONS DR",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875714475",
            "telephone_number": "505-585-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 VALVERDE COMMONS DR",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875714475",
            "telephone_number": "505-585-1355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3737 Sonoma Blvd",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945892201",
            "country_code": "US",
            "telephone_number": "707-553-5814",
            "fax_number": "707-553-5824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 Wyoming Blvd NE Ste 203",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871121033",
            "country_code": "US",
            "telephone_number": "505-585-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATALSKY",
        "first_name": "SHERRY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-07-21",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 19238",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.