Healthcare Provider Details

I. General information

NPI: 1194246462
Provider Name (Legal Business Name): ADA DEL CARMEN SALAZAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N MAIN ST STE B
CLOVIS NM
88101-6606
US

IV. Provider business mailing address

13164 MYSTIC PATH DR
EL PASO TX
79938-3700
US

V. Phone/Fax

Practice location:
  • Phone: 575-265-9903
  • Fax:
Mailing address:
  • Phone: 903-884-4480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-10018
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberX-10076
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-0545
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: