Organization Active NPI

Native Behavioral Health Services, LLC

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1770078321
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-08163 Issued in NM
Legal business name
NATIVE BEHAVIORAL HEALTH SERVICES, LLC
Practice address
4001 Office Court Dr Ste 303
Santa Fe, NM 87507-4930
Phone
(505) 395-9456
Fax
(505) 930-5114
NPI assigned
Jun 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Authorized official

Name
Hal M Agler, LCSWNPI 1558409060
Title
Chief Clinical Officer
Phone
(505) 470-5272

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 C-08163 NM Primary

Addresses

Primary practice location

4001 Office Court Dr Ste 303
Santa Fe, NM 87507-4930

Mailing address

4001 Office Court Dr Ste 303
Santa Fe, NM 87507-4930
Phone (505) 395-9456

Other identifiers 1

IdentifierTypeStateIssuer
432MedicaidNM

National Provider Directory

National Provider Directory

Locations

4001 Office Court Dr
Ste 303
Santa Fe, NM 87507
Phone (505) 395-9456

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": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1770078321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 OFFICE COURT DR STE 303",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074930",
            "telephone_number": "505-395-9456",
            "fax_number": "505-930-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 OFFICE COURT DR STE 303",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074930",
            "telephone_number": "505-395-9456",
            "fax_number": "505-930-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "AGLER",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "505-470-5272",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-08163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.