Individual provider Active NPI

Danielle Juliet Fichera, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1356775456
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-10404 Issued in NM
Practice address
315 Alameda Park Dr, NE
Albuquerque, NM 87113
Phone
(505) 842-9911
Fax
(505) 254-9911
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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 C-10404 NM Primary

Addresses

Primary practice location

315 Alameda Park Dr, NE
Albuquerque, NM 87113

Mailing address

1264 Peppoli Loop SE
Rio Rancho, NM 87124-8782
Phone (505) 712-2190

Other identifiers 1

IdentifierTypeStateIssuer
1356775456MedicaidNM

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
I20180912000611 NM Practitioner - Clinical Social Worker 2365792371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Pathways Psychotherapy Clinical CurrentSince May 24, 2020 Accepting new patients
Healthy Families of Albuquerque LLC Clinical CurrentSince Aug 1, 2018 Accepting new patients

Locations

1803 Carlisle Blvd NE
Albuquerque, NM 87110
Phone (505) 842-9911

315 Alameda Blvd NE
Albuquerque, NM 87113
Phone (505) 712-2190

Organizations & group practices 2

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1356775456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 PEPPOLI LOOP SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871248782",
            "telephone_number": "505-712-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ALAMEDA PARK DR, NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87113",
            "telephone_number": "505-842-9911",
            "fax_number": "505-254-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICHERA",
        "first_name": "DANIELLE",
        "middle_name": "JULIET",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-10404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356775456",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.