Healthcare Provider Details

I. General information

NPI: 1316642754
Provider Name (Legal Business Name): MARIAH HARLEY WHEIR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 DARTMOUTH DR SE APT D
ALBUQUERQUE NM
87106-2261
US

IV. Provider business mailing address

120 DARTMOUTH DR SE APT D
ALBUQUERQUE NM
87106-2261
US

V. Phone/Fax

Practice location:
  • Phone: 505-460-2654
  • Fax: 505-796-5475
Mailing address:
  • Phone: 505-460-2654
  • Fax: 505-796-5475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-1285
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: