Individual provider Active NPI

Wendy Wofford, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1558147173
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2023-0691 Issued in NM
Practice address
1101 Lopez Rd SW
Albuquerque, NM 87105-3954
Phone
(505) 850-2710
NPI assigned
Sep 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2023-0691 NM Primary

Addresses

Primary practice location

1101 Lopez Rd SW
Albuquerque, NM 87105-3954

Mailing address

1101 Lopez Rd SW
Albuquerque, NM 87105-3954
Phone (505) 850-2710

Other names 1

  • Wendy Wickham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Waves Behavioral Health CurrentSince Dec 5, 2024 Accepting new patients

Locations

9400 Holly Ave NE
Bldg 4
Albuquerque, NM 87122
Phone (505) 336-0403

7510 Montgomery Blvd NE
Ste 202
Albuquerque, NM 87109
Phone (505) 514-3972

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1558147173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LOPEZ RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053954",
            "telephone_number": "505-850-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LOPEZ RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053954",
            "telephone_number": "505-850-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOFFORD",
        "first_name": "WENDY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2023-0691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "WICKHAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.