Active NPI
Richard Malcolm, LISW
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1649304668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-3878
- Practice address
- 5310 Sequoia Rd NW
Albuquerque, NM 87120-1249 - Phone
- (505) 836-7330
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | I-3878 | NM | Primary |
Addresses
Primary practice location
5310 Sequoia Rd NW
Albuquerque, NM 87120-1249
Mailing address
PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000S7907 | Medicaid | NM |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-3878 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth & Family Centered Services of NM, Inc Dba Desert Hills | Past | Accepting new patients | |
| Familyworks, Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1255548905
-
- Psychiatric Residential Treatment Facility
- Albuquerque, NM
- NPI 1376606186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505692800000",
"number": "1649304668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26666",
"address_2": "PHS PROVIDER ENROLLMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871256666",
"telephone_number": "505-923-6770",
"fax_number": "505-923-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5310 SEQUOIA RD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871201249",
"telephone_number": "505-836-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALCOLM",
"first_name": "RICHARD",
"credential": "LISW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2017-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-3878",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000S7907",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.