MEDICARE: MS. CELESTE NICOLE MORALES LCSW

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	C-11271	NM

General Provider Information

NPI Number	:	1700174984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CELESTE NICOLE MORALES LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1349
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88062-1349
Country	:	US
Telephone Number	:	575-388-4497
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 E 32ND ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7252
Country	:	US
Telephone Number	:	575-388-4412
Fax Number	:	575-597-2809

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

Provider Enumeration Date	:	07/21/2011
Last Update Date	:	07/16/2021

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