Healthcare Provider Details

I. General information

NPI: 1831935261
Provider Name (Legal Business Name): ALANA DANIELLE FICHMAN MSW
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: ILAN FICHMAN MSW

II. Dates (important events)

Enumeration Date: 07/04/2024
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3908 CARLISLE BLVD NE
ALBUQUERQUE NM
87107-4504
US

IV. Provider business mailing address

3908 CARLISLE BLVD NE
ALBUQUERQUE NM
87107-4504
US

V. Phone/Fax

Practice location:
  • Phone: 707-591-1726
  • Fax:
Mailing address:
  • Phone: 707-591-1726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2024-0676
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: