NPIMap

Individual provider Active NPI

Michelle Baca, LISW

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1912449646
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I-07571 Issued in NM
Practice address
320 Gold Ave SW
Suite 1001
Albuquerque, NM 87102-3202
Phone
(505) 247-4900
Fax
(505) 933-6373
NPI assigned
Nov 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I-07571 NM Primary

Addresses

Primary practice location

320 Gold Ave SW
Suite 1001
Albuquerque, NM 87102-3202

Mailing address

320 Gold Ave SW
Suite 1001
Albuquerque, NM 87102-3202
Phone (505) 247-4900

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

Practice roles

OrganizationSpecialtyStatusNew patients
House Calls of New Mexico LLC PastSince May 1, 2009 Accepting new patients
Southwest Neuropsychology & Behavioral Health Social Worker Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1912449646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 GOLD AVE SW",
            "address_2": "SUITE 1001",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023202",
            "telephone_number": "505-247-4900",
            "fax_number": "505-933-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 GOLD AVE SW",
            "address_2": "SUITE 1001",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023202",
            "telephone_number": "505-247-4900",
            "fax_number": "505-933-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "MICHELLE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "I-07571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; 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.