Healthcare Provider Details

I. General information

NPI: 1750582896
Provider Name (Legal Business Name): SOUTHWEST SERVICES FOR THE DEAF, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2537 ASPEN AVE NW
ALBUQUERQUE NM
87104-1919
US

IV. Provider business mailing address

3301R COORS BLVD NW # 265
ALBUQUERQUE NM
87120-1229
US

V. Phone/Fax

Practice location:
  • Phone: 505-459-9301
  • Fax: 505-884-1081
Mailing address:
  • Phone: 505-459-9301
  • Fax: 505-884-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4226
License Number StateNM

VIII. Authorized Official

Name: LISA WHITNEY SWANSON
Title or Position: PRESIDENT
Credential:
Phone: 505-206-5460