Pamela Anne Risley, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I 05566 Issued in NM

Practice address

127 Eastgate Dr
Suite 206
Los Alamos, NM 87544-3300

Phone

(505) 662-5717

Fax

(505) 662-5717

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407070980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 LA PALOMA DR",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443434",
            "telephone_number": "505-672-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 EASTGATE DR",
            "address_2": "SUITE 206",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443300",
            "telephone_number": "505-662-5717",
            "fax_number": "505-662-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISLEY",
        "first_name": "PAMELA",
        "middle_name": "ANNE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I 05566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95321781",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MESA BLUE CROSS BLUE SHI",
            "identifier": "00JN33",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE BEH HEALTH",
            "identifier": "550010004361",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Los Alamos, NM
• Providers in Los Alamos, 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 Jul 8, 2007; 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.