{"npi":"1104864255","type":"NPI-1","status":"active","name":{"display":"Mrs. Jennifer Rose Lisw","other":[],"first":"JENNIFER","last":"ROSE","middle":"BETH","credential":"LISW"},"specialty":{"primary_taxonomy":"1041C0700X","primary_taxonomy_description":"Clinical Social Worker","slug":"clinical-social-worker","schema_org_specialty":null,"all":[{"code":"1041C0700X","description":"Clinical Social Worker","primary":true,"state":"NM","license":"C-06999"}]},"addresses":[{"purpose":"LOCATION","street_1":"2111 GOLF COURSE RD SE STE D","city":"RIO RANCHO","state":"NM","postal_code":"871241634","country_code":"US","phone":"5056391312"},{"purpose":"MAILING","street_1":"2111 GOLF COURSE RD SE STE D","city":"RIO RANCHO","state":"NM","postal_code":"871241634","country_code":"US","phone":"5056391312"}],"license":{"state":"NM","number":"C-06999"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"02351714","state":"NM","issuer":null},{"type_code":"01","label":"Other","value":"1598218190","state":"NM","issuer":"NPI TYPE 2"},{"type_code":"01","label":"Other","value":"1104864255","state":"NM","issuer":"NPI TYPE"},{"type_code":"05","label":"Medicaid","value":"17301866","state":"NM","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20170306000368","type_code":"14-80","type_desc":"PRACTITIONER - CLINICAL SOCIAL WORKER","state":"NM","pac_id":"6305120668"}]},"enumeration_date":"2006-06-02","last_updated":"2024-02-12","_meta":{"source":"NPPES","snapshot_date":"2024-02-12","doc_url":"https://findmynpi.com/api"}}