Individual provider Active NPI

Craig Spencer Hutton

  • Clinical Social Worker
  • Farmington, NM
National Provider Identifier
1427658145
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
X-10960 Issued in NM
Practice address
116 N Wall Ave
Farmington, NM 87401-6916
Phone
(505) 297-6616
Fax
(505) 787-2411
NPI assigned
Oct 30, 2020
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X X-10960 NM Primary

Addresses

Primary practice location

116 N Wall Ave
Farmington, NM 87401-6916

Mailing address

PO Box 5522
Farmington, NM 87499-5522
Phone (505) 297-6616

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
I20210219001263 NM Practitioner - Clinical Social Worker 3971918103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

116 N Wall Ave
Farmington, NM 87401-6916
Phone (505) 297-6616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X-10960NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Quest Counseling, LLC Clinical CurrentSince Jan 4, 2021 Accepting new patients

Locations

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

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": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1427658145",
    "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": "505-297-6616",
            "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": {
        "last_name": "HUTTON",
        "first_name": "CRAIG",
        "middle_name": "SPENCER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "X-10960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.