Individual provider Active NPI

Denise Saccone, LISW

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1336357680
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I04994 Issued in NM
Practice address
1435 South St Francis Drive
Room 205
Santa Fe, NM 87505
Phone
(505) 501-4410
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I04994 NM Primary

Addresses

Primary practice location

1435 South St Francis Drive
Room 205
Santa Fe, NM 87505

Mailing address

825 Calle Mejia
Apt 431
Santa Fe, NM 87501-1417
Phone (505) 989-1233

Other identifiers 3

IdentifierTypeStateIssuer
17277OtherNMMESA MENTAL HEALTH
00NM00JP23OtherNMBLUE CROSS BLUE SHIELD
70207836MedicaidNM

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

LicenseStateTypeSpecialty
I04994NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336357680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CALLE MEJIA",
            "address_2": "APT 431",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011417",
            "telephone_number": "505-989-1233",
            "fax_number": "505-989-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 SOUTH ST FRANCIS DRIVE",
            "address_2": "ROOM 205",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-501-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACCONE",
        "first_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I04994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MESA MENTAL HEALTH",
            "identifier": "17277",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00NM00JP23",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70207836",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, 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.

Verify at the official NPI Registry.