Individual provider Active NPI

Michaela Granito-Tibbetts, LMSW

  • School Social Worker
  • Santa Fe, NM
National Provider Identifier
1609181429
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
M-05778 Issued in NM
Practice address
1300 Camino Sierra Vis
Santa Fe, NM 87505-1007
Phone
(505) 466-4944
Fax
(505) 467-2648
NPI assigned
Aug 17, 2010
Last updated
Aug 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X M-05778 NM Primary

Addresses

Primary practice location

1300 Camino Sierra Vis
Santa Fe, NM 87505-1007

Mailing address

7 Esquina Rd
Santa Fe, NM 87508-9172
Phone (505) 466-4944

Other identifiers 1

IdentifierTypeStateIssuer
E7606MedicaidNM

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

LicenseStateTypeSpecialty
M-05778NMMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1609181429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ESQUINA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875089172",
            "telephone_number": "505-466-4944",
            "fax_number": "505-467-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CAMINO SIERRA VIS",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051007",
            "telephone_number": "505-466-4944",
            "fax_number": "505-467-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANITO-TIBBETTS",
        "first_name": "MICHAELA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NM",
            "license": "M-05778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E7606",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.