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JACK L. HUMPHRIES LISW LTD. NPI 1043376288


NPI Information

NPI: 1043376288
Provider Name: JACK L. HUMPHRIES, LISW, LTD.
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
8800 PALOMAR AVE NE
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 620-5225
Get Directions

JACK L. HUMPHRIES, LISW, LTD. is a clinical social worker in Albuquerque, NM. The provider is 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. JACK L. HUMPHRIES, LISW, LTD. NPI is 1043376288. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8800 PALOMAR AVE NE
ALBUQUERQUE, NM
ZIP 87109-205
Phone: (505) 620-5225
Fax: (505) 798-1743

The provider's authorized official is Jack L. Humphries .
The authorized official title is President and has the following contact phone number (505) 620-5225.

The enumeration date for this NPI number is 12/30/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalI-3613NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1NM60084MEDICAIDNEW MEXICO
237982788MEDICAIDNEW MEXICO
324500721MEDICAIDNEW MEXICO
4D-4525MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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