Individual provider Active NPI

Jacob P Torrez, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1942516547
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-08866 Issued in NM
Practice address
4412 11TH St NW
Albuquerque, NM 87107-3603
Phone
(505) 290-4769
NPI assigned
Aug 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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-08866 NM Primary

Addresses

Primary practice location

4412 11TH St NW
Albuquerque, NM 87107-3603

Mailing address

4412 11TH St NW
Albuquerque, NM 87107-3603
Phone (505) 290-4769

Other practice location 1

10511 Golf Course Rd NW Ste 102
Albuquerque, NM 87114-5917
Phone (505) 508-0808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20190404000405 NM Practitioner - Clinical Social Worker 1052652856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4412 11TH St NW
Albuquerque, NM 87107-3603
Phone (505) 290-4769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob P. Torrez, LCSW, LLC. CurrentSince Jul 1, 2022 Accepting new patients
Raven Counseling and Wellness LLC Clinical CurrentSince Mar 4, 2019 Accepting new patients

Locations

10511 Golf Course Rd NW
Ste 102
Albuquerque, NM 87114
Phone (505) 508-0808

8625 Golf Course Rd NW
Ste B2
Albuquerque, NM 87114
Phone (505) 508-0808

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1942516547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 11TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871073603",
            "telephone_number": "505-290-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 11TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871073603",
            "telephone_number": "505-290-4769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10511 Golf Course Rd NW Ste 102",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871145917",
            "country_code": "US",
            "telephone_number": "505-508-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORREZ",
        "first_name": "JACOB",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-08866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.