Healthcare Provider Details

I. General information

NPI: 1891331880
Provider Name (Legal Business Name): CHRISTI MICHELLE FIELDS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 LOUISIANA BLVD NE STE A2
ALBUQUERQUE NM
87110-3550
US

IV. Provider business mailing address

800 LOMA LINDA PL SE
ALBUQUERQUE NM
87108-3345
US

V. Phone/Fax

Practice location:
  • Phone: 505-604-0221
  • Fax: 505-448-7884
Mailing address:
  • Phone: 505-604-0221
  • Fax: 505-448-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW94854
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-11005
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: