MANDY MARIE JACQUEZ (NPI# 1750894622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750894622 |
| Entity Type | Individual |
| Full Name | MANDY MARIE JACQUEZ |
| Credential | LCSW |
| Practice Address |
755 S Telshore Blvd D109 Las Cruces NM 88011 |
| Practice Telephone | 5756471604 |
| Mailing Telephone | 5756471604 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C-09154 | NM | Behavioral Health & Social Service Providers |
| Street Address |
755 S TELSHORE BLVD D109 |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954648 | Asc of The Heart Institute | Internal Medicine | 1250 N Sonoma Ranch Blvd, Las Cruces, NM 88011 | 2020-08-26 |
| 1104449206 | Kruti Gitesh Shah | Student in an Organized Health Care Education/Training Program | Mountain View Regional Medical Cente, Graduate Medical Education, 4351 E Lohman Ave Suite 300, Las Cruces, NM 88011 | 2020-05-22 |
| 1831719368 | Borna Mansouri | Student in an Organized Health Care Education/Training Program | 4351 E. Lahman Ave, Suite 300, Moutnainview Regional Medical Center Graduta, Las Cruces, NM 88011 | 2020-04-24 |
| 1306474408 | Madonna Petula Phillip | Student in an Organized Health Care Education/Training Program | 4351 E Lohmon Avenue Suite 300, Las Cruces, NM 88011 | 2020-04-01 |
| 1285267849 | Back In Action Therapy of Las Cruces | Occupational Therapist | 4440 Sonoma Ranch Blvd, Suite F, Las Cruces, NM 88011 | 2020-02-21 |
| 1649818725 | Kimberly Ann Smetzer | Registered Nurse | 4401 East Lohman, Building 5, Las Cruces, NM 88011 | 2019-12-19 |
| 1548806375 | Melinda Michelle Fowler | Social Worker | 2605 Terrace Drive, Las Cruces, NM 88011 | 2019-11-27 |
| 1871134692 | Rio Grande Hematology and Oncology, LLC | Internal Medicine | 4391 East Lohman Ave., Las Cruces, NM 88011 | 2019-10-02 |
| 1972083640 | Lorianna R. Narvaez | Counselor | 1155 S. Telshor Suite 302-a, Las Cruces, NM 88011 | 2018-08-21 |
| 1215416524 | Aday Orthodontics, PC | Dentist | 2701 Missouri Ave., Suite D, Las Cruces, NM 88011 | 2018-08-08 |
| Find all providers in zip 88011 | ||||
| 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 |
| 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 |
| 1619344322 | Jessica Cauthorne | Social Worker | 2971 Long Bow Loop, Las Cruces, NM 88011-5218 | 2015-08-28 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88011 |
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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.