Mary Pattridge, LICSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-09699 Issued in NM

Practice address

800 E 9TH Ave
Truth Or Consequences, NM 87901-1961

Phone

(575) 894-2111

NPI assigned

Sep 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sierra Vista HospitalGroup PAC ID 0143122416, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sierra Vista Hospital

  • Critical Access Hospital
  • Truth Or Consequences, NM
  • NPI 1760446009

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Rick Gilsdorf, LPCC, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alamogordo, NM
  • NPI 1194292672
  NPD (past)
• Sierra Vista Hospital

  • Rural Health Clinic/Center
  • Truth Or Consequences, NM
  • NPI 1689638942
  NPD (past)

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1386952364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 9TH AVE",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879011961",
            "telephone_number": "575-894-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 9TH AVE",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879011961",
            "telephone_number": "575-894-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 Woodlake Dr SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559046242",
            "country_code": "US",
            "telephone_number": "507-289-2089",
            "fax_number": "507-289-2327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTRIDGE",
        "first_name": "MARY",
        "credential": "LICSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "300784",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17648",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saharu Oda, DDS
• Erica Palin, MD
• Paloma Springs Assisted Living LLC
• Paloma Springs Healthcare LLC
• Jorge Partida, MD
• Kathy Jean Perrty, LMT
• Alfadiva Peru
• Alison Rae Phillips, LCSW
• Kacey D Polanco, MPT
• Joseph Anthony Prieto

• Clinical Social Worker in Truth Or Consequences, NM
• Providers in Truth Or Consequences, 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 May 10, 2021; 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.