Individual provider Active NPI

Refina Willie, LCSW

  • Clinical Social Worker
  • Shiprock, NM
National Provider Identifier
1881063568
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-11656 Issued in NM
Practice address
US Hwy 491 N
Shiprock, NM 87420
Phone
(505) 368-6001
Fax
(505) 368-7319
NPI assigned
Sep 23, 2015
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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 C-11656 NM Primary

Addresses

Primary practice location

US Hwy 491 N
Shiprock, NM 87420

Mailing address

PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181213001465 TX Practitioner - Clinical Social Worker 6901141365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

P O Box
160 Attn Business Office
Shiprock, NM 87420-0160

PO Box
Suite 160
Shiprock, NM 87420-0160

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-11656NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 13, 2018 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 13, 2018 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1881063568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 N",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIE",
        "first_name": "REFINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

Verify at the official NPI Registry.