Individual provider Active NPI

Breena S Tafoya, LISW

  • Clinical Social Worker
  • Las Cruces, NM
National Provider Identifier
1851439475
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
715 E Idaho Ave Ste 2E
Las Cruces, NM 88001-4701
Phone
(575) 556-9585
Fax
(575) 556-9456
NPI assigned
Feb 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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 NM Primary

Addresses

Primary practice location

715 E Idaho Ave Ste 2E
Las Cruces, NM 88001-4701

Mailing address

PO Box 727
Mesilla Park, NM 88047-0727
Phone (575) 642-8046

Other identifiers 1

IdentifierTypeStateIssuer
33376824MedicaidNM

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

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1851439475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "MESILLA PARK",
            "state": "NM",
            "postal_code": "880470727",
            "telephone_number": "575-642-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E IDAHO AVE STE 2E",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880014701",
            "telephone_number": "575-556-9585",
            "fax_number": "575-556-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAFOYA",
        "first_name": "BREENA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33376824",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.