Active NPI
Ivan Marie Roque, LCSW
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1447401195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-09696
- Practice address
- 1318 7TH St NW
Albuquerque, NM 87102-1244 - Phone
- (505) 435-0074
- NPI assigned
- Sep 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-09696 | NM | Primary |
Addresses
Primary practice location
1318 7TH St NW
Albuquerque, NM 87102-1244
Mailing address
1318 7TH St NW
Albuquerque, NM 87102-1244
Phone (505) 435-0074
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-09696 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Healthcare Services, Inc. | Current | Accepting new patients | |
| Behavioral Healthcare Services, Inc. | Current | Accepting new patients | |
| The People'S Counseling and Consulting, LLC | Current | Accepting new patients | |
| Dragonfly Counseling Associates Inc. | Past | Accepting new patients |
Locations
707 Broadway Blvd NE
Ste 500
Albuquerque, NM 87102
Phone (505) 248-2726
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1396345328
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Albuquerque, NM
- NPI 1730112483
-
- Community/Behavioral Health Agency
- Santa Fe, NM
- NPI 1255780037
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1033230818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745452800000",
"number": "1447401195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1318 7TH ST NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871021244",
"telephone_number": "505-435-0074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1318 7TH ST NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871021244",
"telephone_number": "505-435-0074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROQUE",
"first_name": "IVAN",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-30",
"last_updated": "2025-04-24",
"certification_date": "2025-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-09696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.