Healthcare Provider Details

I. General information

NPI: 1215201991
Provider Name (Legal Business Name): CORAZON TRAINING AND CONSULTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2012
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 AVENIDA MANANA NE
ALBUQUERQUE NM
87110-5748
US

IV. Provider business mailing address

1401 AVENIDA MANANA NE
ALBUQUERQUE NM
87110-5748
US

V. Phone/Fax

Practice location:
  • Phone: 505-235-2429
  • Fax: 505-254-2294
Mailing address:
  • Phone: 505-235-2429
  • Fax: 505-254-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberM-0827
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1840
License Number StateNM

VIII. Authorized Official

Name: PAULINE LUCERO
Title or Position: DIRECTOR/OWNER
Credential: MA, LMSW, LPCC
Phone: 505-235-2429