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1376879296

NPI Code Detail

MEDICARE: MR. ALAN ALBO LCSW. LADAC

MEDICARE: MR. ALAN ALBO LCSW. LADAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAD0157991	NM
2	1041C0700X	Clinical Social Worker	C-11864	NM
3	104100000X	Social Worker	C-11864	NM

General Provider Information

NPI Number	:	1376879296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALAN ALBO LCSW. LADAC

Provider Business Mailing Address
First Line	:	653 W ARRINGTON ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-8513
Country	:	US
Telephone Number	:	505-564-3733
Fax Number	:	505-564-3788

Provider Business Practice Location Address
First Line	:	653 W ARRINGTON ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-8513
Country	:	US
Telephone Number	:	505-564-3733
Fax Number	:	505-564-3788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2009
Last Update Date	:	07/22/2025

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Directions to “ MR. ALAN ALBO LCSW. LADAC” Practice Location

Language	Start Address	Practice Location

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