Active NPI
Beverly Tamanini, LISW
- Clinical Social Worker
- Gallup, NM
National Provider Identifier
1487907218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- X-07980
- Practice address
- 208 1/2 E Hill Ave
Gallup, NM 87301-6153 - Phone
- (505) 863-1930
- NPI assigned
- Oct 17, 2012
- Sex
- Female
- Sole proprietor
- No
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 | X-07980 | NM | Primary |
Addresses
Primary practice location
208 1/2 E Hill Ave
Gallup, NM 87301-6153
Mailing address
208 1/2 E Hill Ave
Gallup, NM 87301-6153
Phone (505) 863-1930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X-07980 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366588800000",
"number": "1487907218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 1/2 E HILL AVE",
"city": "GALLUP",
"state": "NM",
"postal_code": "873016153",
"telephone_number": "505-863-1930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 1/2 E HILL AVE",
"city": "GALLUP",
"state": "NM",
"postal_code": "873016153",
"telephone_number": "505-863-1930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMANINI",
"first_name": "BEVERLY",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-17",
"last_updated": "2013-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "X-07980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.