Individual provider Active NPI

Tatiana Naumer-Percival, LMSW

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1366960288
Registry record updated Aug 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M-10054 Issued in NM
Practice address
1709 Moon St NE
Albuquerque, NM 87112-3935
Phone
(505) 271-0329
NPI assigned
Aug 30, 2017
Last updated
Aug 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-10054 NM Primary

Addresses

Primary practice location

1709 Moon St NE
Albuquerque, NM 87112-3935

Mailing address

9609 Tanoan Dr NE
Albuquerque, NM 87111-5838
Phone (505) 414-9483

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
M-10054NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Standtall Healing, LLC Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1366960288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9609 TANOAN DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115838",
            "telephone_number": "505-414-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MOON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123935",
            "telephone_number": "505-271-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUMER-PERCIVAL",
        "first_name": "TATIANA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-10054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; 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.