MEDICARE: MONIQUE NUNCIO RODRIGUEZ LCSW, LSAA

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	1041C0700X	Clinical Social Worker	SWB-2023-1285	NM
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CSA0222541	NM

General Provider Information

NPI Number	:	1417604851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE NUNCIO RODRIGUEZ LCSW, LSAA

Provider Business Mailing Address
First Line	:	2269 CIMARRON DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-9006
Country	:	US
Telephone Number	:	832-275-9710
Fax Number	:

Provider Business Practice Location Address
First Line	:	1980 E LOHMAN AVE STE E
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-3194
Country	:	US
Telephone Number	:	575-323-9900
Fax Number	:	575-222-7471

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

Provider Enumeration Date	:	03/06/2022
Last Update Date	:	10/31/2025

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