Chacon Individual & Family Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CHACON INDIVIDUAL & FAMILY THERAPY, LLC

Practice address

1313 Marron Cir NE
Albuquerque, NM 87112-5035

Phone

(505) 315-7900

NPI assigned

Nov 11, 2020

Organization subpart

No

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

Authorized official

Name

Tracy Chacon, LCSW

Title

Owner

Phone

(505) 315-7900

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1669074902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 MARRON CIR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125035",
            "telephone_number": "505-315-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 MARRON CIR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125035",
            "telephone_number": "505-315-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHACON INDIVIDUAL & FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "CHACON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-315-7900",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Cetera-Jines
• Elisabeth H. Ceysens, RD
• CGC LLC
• Lily E. Cha, DDS
• Devon S Chabot-Richards, M.D.
• Gabriela Chacon Palma, MD
• Amanda Chacon, LSAA
• Briana Chacon, PA-C
• Edward J. Chacon
• Flor Magaly Chacon, B.A.

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.

Verify at the official NPI Registry.