Active NPI
Brenda K Baker, LISW
- Clinical Social Worker
- Farmington, NM
National Provider Identifier
1962677492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-07304
- Practice address
- 19 Road 3953
Farmington, NM 87401-7990 - Phone
- (505) 486-9942
- NPI assigned
- Apr 25, 2008
- Last updated
- Jan 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M-06619 | NM | |
| Clinical Social Worker | 1041C0700X | I-07304 | NM | Primary |
Addresses
Primary practice location
19 Road 3953
Farmington, NM 87401-7990
Mailing address
19 Road 3953
Farmington, NM 87401-7990
Phone (505) 486-9942
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28005775 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-06619 | NM | MD | Social Worker |
| I-07304 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Time | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Farmington, NM
- NPI 1306026075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296000000000",
"number": "1962677492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 ROAD 3953",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874017990",
"telephone_number": "505-486-9942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 ROAD 3953",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874017990",
"telephone_number": "505-486-9942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "BRENDA",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-25",
"last_updated": "2011-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-06619",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-07304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "28005775",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.