Healthcare Provider Details

I. General information

NPI: 1346120474
Provider Name (Legal Business Name): EFFIE CLAYTON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 PRINCESS JEANNE AVE NE
ALBUQUERQUE NM
87112-4426
US

IV. Provider business mailing address

6400 UPTOWN BLVD NE
ALBUQUERQUE NM
87110-4202
US

V. Phone/Fax

Practice location:
  • Phone: 505-830-3128
  • Fax:
Mailing address:
  • Phone: 505-880-3700
  • Fax: 505-830-0660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberSWB-2025-0581
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: