Darva Vicki Kinlicheenie, LMSW – School Social Worker

Key facts

NPI: 1467600593
Entity type: Individual (NPI type 1)
Primary specialty: School Social Worker 1041S0200X
License: X-06203 (NM)
Practice address: 2011 Troy King Road
#444
Farmington, NM 87401-1319
Phone: (505) 368-5163
Fax: (505) 368-5502
NPI assigned: Sep 3, 2008
Sex: Female
Sole proprietor: Yes

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 and National Provider Directory roles.

Central Consolidated School District #22 Local Education Agency (LEA) · Shiprock, NM · NPI 1487798567

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
X-06203	NM	MD	School Social Worker

Practice roles

Organization	Specialty	Status	New patients
Central Consolidated School District #22		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
School Social Worker	1041S0200X	X-06203	NM	Yes

Addresses

Primary practice location

2011 Troy King Road
#444
Farmington, NM 87401-1319

Mailing address

PO Box 1319
Shiprock, NM 87420-1319
Phone (505) 368-5163

Other identifiers

Identifier	Type	State	Issuer
J7695	Medicaid	NM

Other providers in Farmington, NM

All providers in Farmington, NM · School Social Worker in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.