Healthcare Provider Details

I. General information

NPI: 1730271016
Provider Name (Legal Business Name): STEFFINITA LOTOYA SMART LCSW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W. LLANO ESTACADO BLVD
CLOVIS NM
88101
US

IV. Provider business mailing address

921 E LLANO ESTACADO BLVD
CLOVIS NM
88101-3807
US

V. Phone/Fax

Practice location:
  • Phone: 575-763-4335
  • Fax: 575-763-4296
Mailing address:
  • Phone: 954-804-0865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberISW3945
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-11879
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: