Active NPI
Su Vida
- Clinical Social Worker
- Santa Fe, NM
National Provider Identifier
1629009899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- SU VIDA
- Practice address
- 1601A Saint Michaels Dr
Santa Fe, NM 87505-7614 - Phone
- (505) 954-8777
- Fax
- (505) 954-8793
- NPI assigned
- Jul 6, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carol J Fitzpatrick, PHD
- Title
- Executive Director/Ceo
- Phone
- (505) 954-8777
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | NU | Primary |
Addresses
Primary practice location
1601A Saint Michaels Dr
Santa Fe, NM 87505-7614
Mailing address
1601A Saint Michaels Dr
Santa Fe, NM 87505-7614
Phone (505) 954-8777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78558 | Medicaid | NM | |
| NM600536 | Other | NM | VALUE OPTIONS |
National Provider Directory
National Provider DirectoryLocations
1601 Saint Michaels Dr
Ste A
Santa Fe, NM 87505
Phone (505) 954-8777
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Mental Health Counselor
- Santa Fe, NM
- NPI 1326079492
-
- Mental Health Counselor
- Santa Fe, NM
- NPI 1003035411
-
- Mental Health Counselor
- Santa Fe, NM
- NPI 1104851534
-
- Mental Health Counselor
- South Burlington, VT
- NPI 1184836793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1629009899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601A SAINT MICHAELS DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057614",
"telephone_number": "505-954-8777",
"fax_number": "505-954-8793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601A SAINT MICHAELS DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057614",
"telephone_number": "505-954-8777",
"fax_number": "505-954-8793"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SU VIDA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-06",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "FITZPATRICK",
"authorized_official_first_name": "CAROL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
"authorized_official_telephone_number": "505-954-8777",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78558",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "NM600536",
"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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.