Individual provider Active NPI

Crystal Joyce Sena

  • Social Worker
  • Fort Sumner, NM
National Provider Identifier
1386941938
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M-07680 Issued in NM
Practice address
546 N. 10TH St
Fort Sumner, NM 88119
Phone
(575) 355-2414
NPI assigned
Feb 17, 2011
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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-07680 NM Primary

Addresses

Primary practice location

546 N. 10TH St
Fort Sumner, NM 88119

Mailing address

PO Box 349
Fort Sumner, NM 88119-0349
Phone (575) 355-2414

Other identifiers 1

IdentifierTypeStateIssuer
S7012MedicaidNM

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-07680NMMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1386941938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 349",
            "city": "FORT SUMNER",
            "state": "NM",
            "postal_code": "881190349",
            "telephone_number": "575-355-2414",
            "fax_number": "575-355-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 N. 10TH ST",
            "city": "FORT SUMNER",
            "state": "NM",
            "postal_code": "88119",
            "telephone_number": "575-355-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENA",
        "first_name": "CRYSTAL",
        "middle_name": "JOYCE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-07680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S7012",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sumner, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.