Individual provider Active NPI

Thomas Joseph Heine, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1811366966
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
M-09319 Issued in NM
Practice address
201 Tulane Dr SE
Albuquerque, NM 87106-1413
Phone
(505) 695-0757
NPI assigned
Sep 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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 M-09319 NM Primary

Addresses

Primary practice location

201 Tulane Dr SE
Albuquerque, NM 87106-1413

Mailing address

3032 Mackland Ave NE
Albuquerque, NM 87106-2018
Phone (505) 695-0757

Other practice location 1

707 Broadway Blvd NE
Ste-500
Albuquerque, NM 87102-2360
Phone (505) 268-0701 ext. 2275

Other identifiers 1

IdentifierTypeStateIssuer
08136874MedicaidNM

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M-09319NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1811366966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 MACKLAND AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062018",
            "telephone_number": "505-695-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 TULANE DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871061413",
            "telephone_number": "505-695-0757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 Broadway Blvd NE",
            "address_2": "Ste-500",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022360",
            "country_code": "US",
            "telephone_number": "505-268-0701 x2275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINE",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "M-09319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08136874",
            "state": "NM"
        }
    ],
    "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 Oct 12, 2023; 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.