Healthcare Provider Details

I. General information

NPI: 1275462640
Provider Name (Legal Business Name): ARGENIS SANTAMARIA LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E AZTEC AVE
GALLUP NM
87301-4803
US

IV. Provider business mailing address

2025 E AZTEC AVE
GALLUP NM
87301-4803
US

V. Phone/Fax

Practice location:
  • Phone: 505-863-3828
  • Fax:
Mailing address:
  • Phone: 505-863-3828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-0555
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: