Organization Active NPI

Life Quest Counseling, LLC

  • Clinical Social Worker
  • Farmington, NM
National Provider Identifier
1417546367
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIFE QUEST COUNSELING, LLC
Practice address
116 N Wall Ave
Farmington, NM 87401-6916
Phone
(505) 297-6616
Fax
(505) 787-2411
NPI assigned
Jan 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Craig Spencer Hutton, LCSWNPI 1427658145
Title
Owner
Phone
(505) 297-6616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

116 N Wall Ave
Farmington, NM 87401-6916

Mailing address

PO Box 5522
Farmington, NM 87499-5522
Phone (505) 297-6166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210219001149 NM Part B Supplier - Clinic/Group Practice 2062827298 Receives reassigned benefits from 1 practitioner
Practice locations: Farmington, NM

National Provider Directory

National Provider Directory

Locations

116 N Wall Ave
Farmington, NM 87401
Phone (505) 297-6616

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1417546367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5522",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874995522",
            "telephone_number": "505-297-6166",
            "fax_number": "505-787-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N WALL AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016916",
            "telephone_number": "505-297-6616",
            "fax_number": "505-787-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE QUEST COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "HUTTON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-297-6616",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.