Healthcare Provider Details

I. General information

NPI: 1023148715
Provider Name (Legal Business Name): ANNETTE NANEZ ACOSTA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTRAL
BAYARD NM
88023
US

IV. Provider business mailing address

P.O. BOX 369
SILVER CITY NM
88062
US

V. Phone/Fax

Practice location:
  • Phone: 505-537-4000
  • Fax: 505-537-3921
Mailing address:
  • Phone: 505-534-4228
  • Fax: 505-537-3921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM3693
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM3693
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: