Individual provider Active NPI

Elva Burillo, LCSW

  • Clinical Social Worker
  • Roswell, NM
National Provider Identifier
1568316453
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2025-1343 Issued in NM
Practice address
400 E College Blvd Ste A1
Roswell, NM 88201-7571
Phone
(575) 910-1440
NPI assigned
Feb 25, 2026
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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-2025-1343 NM Primary

Addresses

Primary practice location

400 E College Blvd Ste A1
Roswell, NM 88201-7571

Mailing address

PO Box 832
Roswell, NM 88202-0832

Other practice location 1

1400A N Washington Ave
Roswell, NM 88201-8267
Phone (575) 910-1440

Other identifiers 1

IdentifierTypeStateIssuer
N0050242MedicaidNM

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
I20260407001840 NM Practitioner - Clinical Social Worker 0648745794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1409 Mossman Dr
Roswell, NM 88201-1149

PO Box
Roswell, NM 88202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWB-2025-1343NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Evora Therapy Services LLC Clinical CurrentSince Mar 3, 2026 Accepting new patients
Renew Physical Therapy PC PastSince Mar 3, 2026 Accepting new patients

Locations

1400 N Washington Ave
Ste A
Roswell, NM 88201
Phone (575) 910-1440

400 E College Blvd
Ste A1
Roswell, NM 88201

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": "1771977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1568316453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 832",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882020832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E COLLEGE BLVD STE A1",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882017571",
            "telephone_number": "575-910-1440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400A N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "NM",
            "postal_code": "882018267",
            "country_code": "US",
            "telephone_number": "575-910-1440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURILLO",
        "first_name": "ELVA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-25",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2025-1343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0050242",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.