Marisa C de Baca, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SWB-2026-0383 Issued in NM

Practice address

105 Bertha Rd
Taos, NM 87571-7148

Phone

(575) 758-4297

Fax

(575) 751-4237

NPI assigned

Jul 17, 2023

Last updated

Oct 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1356020291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SAN FRANCISCO ST UNIT 377",
            "city": "RANCHOS DE TAOS",
            "state": "NM",
            "postal_code": "875574016",
            "telephone_number": "575-224-2085",
            "fax_number": "575-751-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BERTHA RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875717148",
            "telephone_number": "575-758-4297",
            "fax_number": "575-751-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "C DE BACA",
        "first_name": "MARISA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2026-0383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Burton
• Lisa K Bushnell, C.F.N.P.
• Andrea Elaine Bustamante, ND, DOM
• Daisy Bustillos
• Travis L Bye
• C. T. Simms, D.D.S., P.C. (C. Tom Simms, D.D.S.)
• Eliza Cain, LMHC
• Calmar Inc. (A & R Medical Supply)
• Cynthia Campbell, SLP
• Mary Margaret Campbell, LADAC

• Clinical Social Worker in Taos, NM
• Providers in Taos, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.