Individual provider Active NPI

Teresa J Graber, LCSW

  • Clinical Social Worker
  • Rio Rancho, NM
National Provider Identifier
1871675140
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-05037 Issued in NM
Practice address
184 Unser Blvd NE
Rio Rancho, NM 87124-4045
Phone
(505) 896-0928
Fax
(505) 896-0585
NPI assigned
Oct 19, 2006
Last updated
Mar 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 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 I-05037 NM Primary

Addresses

Primary practice location

184 Unser Blvd NE
Rio Rancho, NM 87124-4045

Mailing address

6200 Montano Plaza Dr NW
Apt 1724
Albuquerque, NM 87120-5747
Phone (340) 201-7173

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

State licenses

LicenseStateTypeSpecialty
I-05037NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1871675140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 MONTANO PLAZA DR NW",
            "address_2": "APT 1724",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205747",
            "telephone_number": "340-201-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 UNSER BLVD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244045",
            "telephone_number": "505-896-0928",
            "fax_number": "505-896-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "TERESA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.