TONY BOBADILLA (NPI# 1710310016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710310016 |
| Entity Type | Individual |
| Full Name | TONY BOBADILLA |
| Credential | LCSW, PHD |
| Practice Address |
505 S Main St Ste 249 Las Cruces NM 88001-1206 |
| Practice Telephone | 5755275884 |
| Practice Fax Number | 5755275886 |
| Mailing Telephone | (575) 527-5884 |
| Mailing Fax Number | 5755275886 |
| Enumeration Date | 2013-08-10 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | M-08350 | NM | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C-09780 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | NM REG & LICENSING DEPT | C-09780 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1681 Hickory Loop, Las Cruces, NM 880056502 | 5756473773 | 5756473777 |
| 1271 Anthony Drive, Anthony, NM 88021 | 5758823401 | 5758823256 |
| Street Address |
505 S MAIN ST STE 249 |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88001-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629061783 | Jeanne Provencio | Counselor | 505 S Main St, Ste. 129, Las Cruces, NM 88001-1206 | 2005-08-24 |
| 1528692324 | Tahnee Poppy | Psychologist | 505 S Main St, Las Cruces, NM 88001-1206 | 2020-03-02 |
| 1437662699 | Victoria Faith Aguirre | Speech-Language Pathologist | 505 S Main St, Las Cruces, NM 88001-1206 | 2017-11-09 |
| 1245771278 | Kathleen Douglas | Registered Nurse | 505 S Main St, Ste. 249, Las Cruces, NM 88001-1206 | 2017-03-09 |
| 1568900694 | Diana Yandell | Registered Nurse | 505 S Main St, Suite 249, Las Cruces, NM 88001-1206 | 2017-02-09 |
| 1952849325 | Sonya C Martinez | Registered Nurse | 505 S Main St, Ste. 249, Las Cruces, NM 88001-1206 | 2017-02-06 |
| 1902348790 | Blanca E Martinez-rolle | Psychologist | 505 S Main St, Ste. 249, Las Cruces, NM 88001-1206 | 2016-11-09 |
| 1861940074 | Dorie Amber Dwyer | Registered Nurse | 505 S Main St, Suite 249, Las Cruces, NM 88001-1206 | 2016-09-15 |
| 1760937080 | Karen Alcantar | Psychologist | 505 S Main St, Ste 249, Las Cruces, NM 88001-1206 | 2016-08-16 |
| 1841647773 | Justa Ordorica | Registered Nurse | 505 S Main St, Suite 249, Las Cruces, NM 88001-1206 | 2016-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020044 | Three Crosses Regional Hospital LLC | General Acute Care Hospital | 2560 Samaritan Drive, Las Cruces, NM 88001 | 2019-12-17 |
| 1760961908 | Halcyon Health of The Southwest, LLC | Nurse Practitioner | 1355 California Ave Ste B, Las Cruces, NM 88001 | 2018-08-08 |
| 1255818530 | Lago Claro, LLC | Counselor | 2410 S. Espina St, Las Cruces, NM 88001 | 2018-07-19 |
| 1407371818 | Elijah Daniel Perez | Behavior Technician | 1535 Myrtle Ave, Las Cruces, NM 88001 | 2017-08-07 |
| 1982128641 | Krystal Marie Ruiz | Psychologist | 505 S. Main, Ste. 249, Las Cruces, NM 88001 | 2017-08-03 |
| 1457886913 | Mathew Petersen Dds PC | Dentist | 2001 E. Lohman Ave. Suite 121, Las Cruces, NM 88001 | 2017-04-21 |
| 1801343439 | Celia Holmes | Registered Nurse | 505 S Main, Ste 249, Las Cruces, NM 88001 | 2016-09-01 |
| 1427420223 | Sara Guidetti | Family Medicine | 3080 Breland Drive, Las Cruces, NM 88001 | 2015-10-20 |
| 1679987234 | Maria De Jesus Martinez | Nurse Practitioner | 1170 N. Solano Ste A, Las Cruces, NM 88001 | 2014-06-11 |
| 1851701494 | Viola E Garcia | Case Manager/Care Coordinator | 100 W Griggs, Las Cruces, NM 88001 | 2014-05-05 |
| Find all providers in zip 88001 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144849209 | Kristin M Doherty | Social Worker | 1106 Golf Club Rd, Las Cruces, NM 88011-4000 | 2020-04-09 |
| 1801425756 | Zia Vista Therapy, LLC | Social Worker | 1181 Mall Dr Ste E, Las Cruces, NM 88011-8105 | 2020-04-03 |
| 1194365197 | Organ Mountain Counseling, LLC | Social Worker | 1990 E Lohman Ave Ste 209, Las Cruces, NM 88001-3172 | 2020-01-08 |
| 1568927135 | Terri L Alvarez | Social Worker | 2290 Thomas Dr, Las Cruces, NM 88001-5240 | 2019-02-07 |
| 1750894622 | Mandy Marie Jacquez | Social Worker | 755 S Telshore Blvd, D109, Las Cruces, NM 88011 | 2017-11-14 |
| 1225552656 | Andrea Lea Gardner | Social Worker | 151 S Walnut St Ste C6, Las Cruces, NM 88001-2617 | 2017-07-27 |
| 1215380696 | Berta Alicia Covey | Social Worker | 1955 Carlyle Dr, Las Cruces, NM 88005-1635 | 2016-07-20 |
| 1164870754 | Megan Goepfert | Social Worker | 2801 Missouri Ave Ste 8, Las Cruces, NM 88011-5061 | 2016-05-24 |
| 1861865396 | Charles Warren Gillard | Social Worker | 4835 Emerald St, Las Cruces, NM 88012-9433 | 2015-11-05 |
| 1104298181 | Crystal Marie Tapia | Social Worker | 2001 E Lohman Ave Ste 110, Las Cruces, NM 88001-3197 | 2015-10-29 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88001 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.