Deidra Marie Cordova, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-10903 Issued in NM

Practice address

2534 Ridge Runner Rd
Las Vegas, NM 87701-4971

Phone

(505) 617-1180

NPI assigned

Dec 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Oasis Therapy LLC

  • Social Worker
  • Las Vegas, NM
  • NPI 1003490269
  Medicare reassignment NPD Authorized official
• Oasis Therapy, LLC

  • Clinical Social Worker
  • Mora, NM
  • NPI 1588239644
  NPD Authorized official

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1851806525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 UNIVERSITY AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 RIDGE RUNNER RD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014971",
            "telephone_number": "505-617-1180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 University Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NM",
            "postal_code": "877014278",
            "country_code": "US",
            "telephone_number": "505-425-1910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "DEIDRA",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-09998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-10903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Marie Colonna, OTR/L
• Duston Kory Compton, PHARMD
• Consejos-City of Las Vegas
• Contreras Counseling, LLC
• Diane Contreras, LPCC
• James Lee Cordova
• Vanessa Cordova
• Alicia Cortez, L.M.H.C.
• Margaret L Coryat, RPH
• Heather Cox, LMSW

• Clinical Social Worker in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.