Jill Anne Fernandez, LCSW

Individual provider Active NPI Clinical Social Worker · Raton, NM

NPI 1922299460 · NPPES record last updated May 1, 2026

Key facts

NPI
1922299460
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C-08359 (NM)
Practice address
101 N 2ND St
Raton, NM 87740-3803
Phone
(575) 445-7090
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C-08359NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
High Plains Regional Education Coop Past Accepting new patients
Sangre de Cristo Community Health Partnership Mental Health Past Accepting new patients
High Plains Regional Educational Coop Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-08359 NM Yes

Addresses

Primary practice location

101 N 2ND St
Raton, NM 87740-3803

Mailing address

2632 Aguilar Dr
Trinidad, CO 81082-3937
Phone (719) 859-0347

Other identifiers

IdentifierTypeStateIssuer
1041C0700XMedicaidNM

Other providers in Raton, NM

All providers in Raton, NM · Clinical Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.