Individual provider Active NPI

Vanya Garabedian, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1669756185
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C09065 Issued in NM
Practice address
306 Washington St SE
Albuquerque, NM 87108-2735
Phone
(505) 980-0954
NPI assigned
Oct 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C09065 NM Primary

Addresses

Primary practice location

306 Washington St SE
Albuquerque, NM 87108-2735

Mailing address

PO Box 4642
Albuquerque, NM 87196-4642
Phone (505) 980-0954

Other practice location 1

4116 Lomas Blvd NE
Albuquerque, NM 87110-7747
Phone (505) 980-0954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C09065NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Intentional Path Counseling LLC Clinical CurrentSince May 31, 2020 Accepting new patients

Locations

4116 Lomas Blvd NE
Albuquerque, NM 87110
Phone (505) 980-0954

306 Washington St SE
Albuquerque, NM 87108
Phone (505) 456-5400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1669756185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4642",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871964642",
            "telephone_number": "505-980-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WASHINGTON ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082735",
            "telephone_number": "505-980-0954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4116 Lomas Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871107747",
            "country_code": "US",
            "telephone_number": "505-980-0954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARABEDIAN",
        "first_name": "VANYA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C09065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.