Individual provider Active NPI

Loren Elmaleh, LISW

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1679697635
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-06918 Issued in NM
Practice address
905 Lorenzo St
Santa Fe, NM 87501-2463
Phone
(505) 471-5006
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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 I-06918 NM Primary

Addresses

Primary practice location

905 Lorenzo St
Santa Fe, NM 87501-2463

Mailing address

905 Lorenzo St
Santa Fe, NM 87501-2463

Other identifiers 1

IdentifierTypeStateIssuer
71678352MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150610001369 NM Practitioner - Clinical Social Worker 3779804117 Practice locations: Santa Fe, NM

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

905 Lorenzo St
Santa Fe, NM 87501-2463
Phone (505) 501-9310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-06918NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1679697635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 LORENZO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875012463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 LORENZO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875012463",
            "telephone_number": "505-471-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMALEH",
        "first_name": "LOREN",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-06918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71678352",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.