Individual provider Active NPI

Connie Jaimie Huynh

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1477224996
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M-11368 Issued in NM
Practice address
901 Rio Grande Blvd NW Ste G252
Albuquerque, NM 87104-2059
Phone
(505) 702-8112
NPI assigned
Sep 23, 2021
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-11368 NM Primary

Addresses

Primary practice location

901 Rio Grande Blvd NW Ste G252
Albuquerque, NM 87104-2059

Mailing address

901 Rio Grande Blvd NW Ste G252
Albuquerque, NM 87104-2059
Phone (505) 702-8112

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
I20260204001404 NM Practitioner - Clinical Social Worker 2567940125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13 Seclusion CT
Sandia Park, NM 87047-9532

341 51St St NW
Albuquerque, NM 87105-1707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M-11368NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trail Ahead Therapy, LLC Social Worker CurrentSince Sep 28, 2021 Accepting new patients
Lucky Orange Therapy CurrentSince Jan 1, 2026 Accepting new patients

Locations

901 Rio Grande Blvd NW
Ste G252
Albuquerque, NM 87104
Phone (505) 249-2798

Organizations & group practices 2

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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1477224996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 RIO GRANDE BLVD NW STE G252",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042059",
            "telephone_number": "505-702-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 RIO GRANDE BLVD NW STE G252",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042059",
            "telephone_number": "505-702-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "CONNIE",
        "middle_name": "JAIMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-11368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.