Individual provider Active NPI

Anna Lyn Day Vendrely, LCSW

  • Clinical Social Worker
  • Las Cruces, NM
National Provider Identifier
1780815019
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-07884 Issued in NM
Practice address
3100 Oak St
Las Cruces, NM 88005-3425
Phone
(575) 323-3354
NPI assigned
Aug 4, 2009
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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 C-07884 NM Primary

Addresses

Primary practice location

3100 Oak St
Las Cruces, NM 88005-3425

Mailing address

PO Box 3075
Mesilla Park, NM 88047-3075
Phone (575) 640-0742

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
I20140609001658 NM Practitioner - Clinical Social Worker 5991929184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2801 Missouri Ave
Suite 8
Las Cruces, NM 88011-5061
Phone (575) 640-0742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-07884NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aldv, LLC CurrentSince Apr 23, 2020 Accepting new patients

Locations

2801 Missouri Ave
Ste 8
Las Cruces, NM 88011
Phone (575) 242-1100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1780815019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3075",
            "city": "MESILLA PARK",
            "state": "NM",
            "postal_code": "880473075",
            "telephone_number": "575-640-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OAK ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053425",
            "telephone_number": "575-323-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDRELY",
        "first_name": "ANNA",
        "middle_name": "LYN DAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-07884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.