Individual provider Active NPI

Joan Maccracken, LCSW

  • Social Worker
  • Taos, NM
National Provider Identifier
1407993934
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M -05383 Issued in NM
Practice address
125 La Posta Rd Ste 6
Taos, NM 87571-7242
Phone
(575) 770-3126
Fax
(888) 827-0978
NPI assigned
Feb 1, 2007
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 -05383 NM Primary

Addresses

Primary practice location

125 La Posta Rd Ste 6
Taos, NM 87571-7242

Mailing address

PO Box 325
Arroyo Seco, NM 87514-0325
Phone (575) 770-3126

Other practice location 1

HC 74 Box 21859
El Prado, NM 87529-9542
Phone (505) 770-3126

Other practice location 2

104 Martyrs Ln Unit O
Taos, NM 87571-5918
Phone (575) 770-3126

Other identifiers 1

IdentifierTypeStateIssuer
91385547MedicaidNM

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200415000556 NM Practitioner - Clinical Social Worker 2365872371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

77 Martinez Rd
El Prado, NM 87529
Phone (575) 770-3126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M -05383NMMDSocial Worker

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1407993934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "ARROYO SECO",
            "state": "NM",
            "postal_code": "875140325",
            "telephone_number": "575-770-3126",
            "fax_number": "888-827-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LA POSTA RD STE 6",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875717242",
            "telephone_number": "575-770-3126",
            "fax_number": "888-827-0978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "HC 74 Box 21859",
            "address_purpose": "LOCATION",
            "city": "El Prado",
            "state": "NM",
            "postal_code": "875299542",
            "country_code": "US",
            "telephone_number": "505-770-3126",
            "fax_number": "505-758-2465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Martyrs Ln Unit O",
            "address_purpose": "LOCATION",
            "city": "Taos",
            "state": "NM",
            "postal_code": "875715918",
            "country_code": "US",
            "telephone_number": "575-770-3126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACCRACKEN",
        "first_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M -05383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91385547",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.