Healthcare Provider Details

I. General information

NPI: 1548681901
Provider Name (Legal Business Name): ELIZABETH ALONSO-CROSGROVE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2014
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 TIJERAS AVE NW
ALBUQUERQUE NM
87102-3099
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-242-1010
  • Fax: 505-242-1551
Mailing address:
  • Phone: 505-272-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-08745
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: