Healthcare Provider Details

I. General information

NPI: 1679206619
Provider Name (Legal Business Name): ERIN SHATZER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN SHOWEN

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 CARLISLE BLVD NE STE A
ALBUQUERQUE NM
87110-4971
US

IV. Provider business mailing address

7024 MOUNTAIN HAWK LOOP NE
RIO RANCHO NM
87144-7625
US

V. Phone/Fax

Practice location:
  • Phone: 505-750-4243
  • Fax:
Mailing address:
  • Phone: 913-669-4610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2024-1193
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: