Individual provider Active NPI

Lorraine Guillen

  • Clinical Social Worker
  • Las Cruces, NM
National Provider Identifier
1376107649
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-07456 Issued in NM
Practice address
715 E Idaho Ave Ste 2B
Las Cruces, NM 88001-4701
Phone
(575) 556-9585
Fax
(575) 556-9456
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 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-07456 NM Primary

Addresses

Primary practice location

715 E Idaho Ave Ste 2B
Las Cruces, NM 88001-4701

Mailing address

715 E Idaho Ave Ste 2B
Las Cruces, NM 88001-4701
Phone (575) 556-9585

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
C-07456NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1376107649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E IDAHO AVE STE 2B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880014701",
            "telephone_number": "575-556-9585",
            "fax_number": "575-556-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E IDAHO AVE STE 2B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880014701",
            "telephone_number": "575-556-9585",
            "fax_number": "575-556-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLEN",
        "first_name": "LORRAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-07456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.