Individual provider Active NPI

Raquel Tereza Guzman Vega, LCSW

  • Clinical Social Worker
  • Rio Rancho, NM
National Provider Identifier
1861994774
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2024-1148 Issued in NM
Practice address
1005 21St St SE Ste B
Rio Rancho, NM 87124-4030
Phone
(505) 353-2061
NPI assigned
Mar 6, 2018
Reactivated
Aug 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SWB-2022-0803 NM
Clinical Social Worker 1041C0700X SWB-2024-1148 NM Primary

Addresses

Primary practice location

1005 21St St SE Ste B
Rio Rancho, NM 87124-4030

Mailing address

PO Box 15248
Rio Rancho, NM 87174-0248
Phone (505) 339-6938

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241218000173 NM Practitioner - Clinical Social Worker 3173058963 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWB-2022-0803NMMDMental Health Counselor
SWB-2024-1148NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Supports, LLC CurrentSince Nov 1, 2022 Accepting new patients
Sanamente, LLC Clinical CurrentSince Nov 6, 2024 Accepting new patients

Locations

1005 21st St SE
Unit B1
Rio Rancho, NM 87124
Phone (505) 339-6938

1005 21st St SE
Ste B
Rio Rancho, NM 87124
Phone (505) 353-2061

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1861994774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15248",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871740248",
            "telephone_number": "505-339-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 21ST ST SE STE B",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244030",
            "telephone_number": "505-353-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN VEGA",
        "first_name": "RAQUEL",
        "middle_name": "TEREZA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "deactivation_date": "2018-10-28",
        "reactivation_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "SWB-2022-0803",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2024-1148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.