Vicki Fuller Allen, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I05940 Issued in NM

Practice address

530 De Moss St
Hildago Medical Services
Lordsburg, NM 88045-2618

Phone

(575) 542-8384

Fax

(575) 542-8387

NPI assigned

Jul 18, 2005

Last updated

Mar 4, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1912906322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DE MOSS ST",
            "city": "LORDSBURG",
            "state": "NM",
            "postal_code": "880452618",
            "telephone_number": "575-542-8384",
            "fax_number": "575-542-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 DE MOSS ST",
            "address_2": "HILDAGO MEDICAL SERVICES",
            "city": "LORDSBURG",
            "state": "NM",
            "postal_code": "880452618",
            "telephone_number": "575-542-8384",
            "fax_number": "575-542-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "VICKI",
        "middle_name": "FULLER",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I05940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49878531",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lordsburg, NM
• Providers in Lordsburg, 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 Mar 4, 2008; 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.