Healthcare Provider Details

I. General information

NPI: 1902608268
Provider Name (Legal Business Name): JESSICA CURRIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 HOTEL CIR NE
ALBUQUERQUE NM
87123-1202
US

IV. Provider business mailing address

69 HOTEL CIR NE
ALBUQUERQUE NM
87123-1202
US

V. Phone/Fax

Practice location:
  • Phone: 505-237-2374
  • Fax:
Mailing address:
  • Phone: 505-237-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number432842
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2024-1307
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: