Active NPI
Denise Saccone, LISW
- Clinical Social Worker
- Santa Fe, NM
National Provider Identifier
1336357680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I04994
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17277 | Other | NM | MESA MENTAL HEALTH |
| 00NM00JP23 | Other | NM | BLUE CROSS BLUE SHIELD |
| 70207836 | Medicaid | NM |
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 |
|---|---|---|---|
| I04994 | NM | MD | Clinical 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.