Organization Active NPI

Sally Jo Warnick, Lisw Psychotherapy Practice

  • Clinical Social Worker
  • Ranchos de Taos, NM
National Provider Identifier
1851774426
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-4486 Issued in NM
Legal business name
SALLY JO WARNICK, LISW PSYCHOTHERAPY PRACTICE
Practice address
25 Nickell Rd
Ranchos de Taos, NM 87557-9709
Phone
(575) 776-7432
NPI assigned
Jul 1, 2015
Last updated
May 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Ms. Sally Jo Warnick, LISWNPI 1356420236
Title
Therapist
Phone
(575) 776-7432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-4486 NM Primary

Addresses

Primary practice location

25 Nickell Rd
Ranchos de Taos, NM 87557-9709

Mailing address

PO Box 2629
Taos, NM 87571-2629
Phone (575) 776-7432

Other identifiers 1

IdentifierTypeStateIssuer
59635533MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151016000106 NM Part B Supplier - Clinic/Group Practice 4385953223 Receives reassigned benefits from 1 practitioner
Practice locations: Racnchos de Taos, NM

National Provider Directory

National Provider Directory

Locations

125 La Posta Rd
Ste A
Taos, NM 87571
Phone (575) 404-0743

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1851774426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2629",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875712629",
            "telephone_number": "575-776-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NICKELL RD",
            "city": "RANCHOS DE TAOS",
            "state": "NM",
            "postal_code": "875579709",
            "telephone_number": "575-776-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY JO WARNICK, LISW PSYCHOTHERAPY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "WARNICK",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "575-776-7432",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-4486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59635533",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ranchos de Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.