Active NPI
Michelle Bernadette Reyes, LCSW
- Clinical Social Worker
- Cannon Air Force Base, NM
National Provider Identifier
1790366797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 65726
- Practice address
- 224 West D.L. Ingram Ave., BLDG. 1408
Cannon Air Force Base, NM 88103-5014 - Phone
- (505) 784-2778
- NPI assigned
- Apr 20, 2021
- Last updated
- Jun 26, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 65726 | TX | Primary |
| Clinical Social Worker | 1041C0700X | 20789 | OK |
Addresses
Primary practice location
224 West D.L. Ingram Ave., BLDG. 1408
Cannon Air Force Base, NM 88103-5014
Mailing address
224 West D.L. Ingram Ave., BLDG. 1408
Cannon Air Force Base, NM 88103-5014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20789 | OK | MD | Clinical Social Worker |
| 65726 | TX | MD | Pharmacist |
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": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1790366797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 WEST D.L. INGRAM AVE., BLDG. 1408",
"city": "CANNON AIR FORCE BASE",
"state": "NM",
"postal_code": "881035014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 WEST D.L. INGRAM AVE., BLDG. 1408",
"city": "CANNON AIR FORCE BASE",
"state": "NM",
"postal_code": "881035014",
"telephone_number": "505-784-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "MICHELLE",
"middle_name": "BERNADETTE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "65726",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "20789",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cannon Air Force Base, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.