Individual provider Active NPI

Mauricio Lopez-Marquez, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1447675095
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-10318 Issued in NM
Practice address
5501 Wilshire Ave NE
Albuquerque, NM 87113-1950
Phone
(505) 218-1552
NPI assigned
Feb 19, 2014
Last updated
Aug 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-09261 NM
Clinical Social Worker 1041C0700X C-10318 NM Primary

Addresses

Primary practice location

5501 Wilshire Ave NE
Albuquerque, NM 87113-1950

Mailing address

2504 Camino Entrada
Santa Fe, NM 87507-4851
Phone (505) 471-5006

Other names 1

  • Mauricio Lopez-Marquez Professional name

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
I20180717001560 NM Practitioner - Clinical Social Worker 2163779588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M-09261NMMDSocial Worker
C-10318NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mora Valley Community Health Services, Inc. CurrentSince Sep 23, 2024 Accepting new patients
Mora Valley Community Health Services Inc CurrentSince Sep 23, 2024 Accepting new patients
Daybreak Councelors, LLC Clinical CurrentSince Mar 17, 2024 Accepting new patients
Sandia Family Therapy Clinical PastSince Sep 20, 2022 Accepting new patients

Locations

4001 Office Court Dr
Ste 403
Santa Fe, NM 87507
Phone (505) 395-9456

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, 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": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1447675095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 CAMINO ENTRADA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074851",
            "telephone_number": "505-471-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 WILSHIRE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131950",
            "telephone_number": "505-218-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-MARQUEZ",
        "first_name": "MAURICIO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-09261",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-10318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURICIO",
            "last_name": "LOPEZ-MARQUEZ",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.