Healthcare Provider Details

I. General information

NPI: 1275314015
Provider Name (Legal Business Name): LOWKEY AND SERENE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5640 VENICE AVE NE STE L
ALBUQUERQUE NM
87113-2350
US

IV. Provider business mailing address

555 CAMPFIRE RD SE
RIO RANCHO NM
87124-2304
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-1920
  • Fax:
Mailing address:
  • Phone: 505-980-0630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: VICKI LIEBERSPIESS
Title or Position: OWNER
Credential: LCSW
Phone: 505-226-1926