NPIMap

Organization Active NPI

Gina Simon Lisw PC

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1649637125
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I3207 Issued in NM
Legal business name
GINA SIMON LISW PC
Practice address
2729 Mesilla St NE
Albuquerque, NM 87110-3539
Phone
(505) 249-8764
NPI assigned
Jan 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
Gina Simon, LISWNPI 1942351580
Title
Owner
Phone
(505) 249-8764

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X I3207 NM Primary

Addresses

Primary practice location

2729 Mesilla St NE
Albuquerque, NM 87110-3539

Mailing address

2729 Mesilla St NE
Albuquerque, NM 87110-3539

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1649637125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2729 MESILLA ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 MESILLA ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103539",
            "telephone_number": "505-249-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GINA SIMON LISW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-249-8764",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I3207",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 28, 2016; 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.