Individual provider Active NPI

Kathleen NMN Manygoats, MSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1780794057
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0459 Issued in NM
Practice address
801 Vassar Dr NE
Albuquerque, NM 87106-2725
Phone
(505) 248-4083
Fax
(505) 248-7733
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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-0459 NM Primary

Addresses

Primary practice location

801 Vassar Dr NE
Albuquerque, NM 87106-2725

Mailing address

801 Vassar Dr NE
Albuquerque, NM 87106-2725
Phone (505) 248-4083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0459NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780794057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 VASSAR DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062725",
            "telephone_number": "505-248-4083",
            "fax_number": "505-248-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 VASSAR DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062725",
            "telephone_number": "505-248-4083",
            "fax_number": "505-248-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANYGOATS",
        "first_name": "KATHLEEN",
        "middle_name": "NMN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-0459",
            "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 Jul 8, 2007; 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.