Active NPI
Shelly Marie Aultman, LBSW
- Social Worker
- Albuquerque, NM
National Provider Identifier
1972721082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 3075-S
- Practice address
- 805 Tijeras Ave NW
Albuquerque, NM 87102-3099 - Phone
- (505) 242-1010
- Fax
- (505) 242-1551
- NPI assigned
- Apr 23, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3075-S | NV | Primary |
Addresses
Primary practice location
805 Tijeras Ave NW
Albuquerque, NM 87102-3099
Mailing address
3120 Brian Meadows PL NW
Albuquerque, NM 87120-8808
Phone (505) 261-0163
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3075-S | NV | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads for Women | 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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1154536290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972721082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3120 BRIAN MEADOWS PL NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871208808",
"telephone_number": "505-261-0163",
"fax_number": "505-242-1551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 TIJERAS AVE NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023099",
"telephone_number": "505-242-1010",
"fax_number": "505-242-1551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AULTMAN",
"first_name": "SHELLY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NV",
"license": "3075-S",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.