Mimir Jottun Everett, MS, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-11784 Issued in NM

Practice address

901 Rio Grande Blvd NW Ste G252
Albuquerque, NM 87104-2050

Phone

(505) 702-8112

NPI assigned

Jun 25, 2021

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trail Ahead Therapy LLCGroup PAC ID 4789096884, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Trail Ahead Therapy, LLC

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1235733437

  Clinical, NM

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1790355477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 RIO GRANDE BLVD NW STE G252",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042050",
            "telephone_number": "505-720-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 RIO GRANDE BLVD NW STE G252",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042050",
            "telephone_number": "505-702-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "MIMIR",
        "middle_name": "JOTTUN",
        "credential": "MS, LCSW",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2021-06-25",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "26642",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeverett@sageclinic.org",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Sage Neuroscience Center INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7850 Jefferson St NE Ste 300",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871094314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danielle Everett
• Eileen Everett
• Jasmine Everett
• Judith Everett, RN
• Julie Colette Everett, MD
• Sarah Everett, LCSW
• Everette Home Care
• Tory Everhart, LISW
• Evernorth Care Providers - Arizona PC
• Robert N Evers, ATC

• All providers in Albuquerque, NM
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.