Healthcare Provider Details

I. General information

NPI: 1689811689
Provider Name (Legal Business Name): CATHERINE ANN DIOSDADO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE ANN SIMS LCSW

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E CLINTON ST
HOBBS NM
88240-8238
US

IV. Provider business mailing address

315 E CLINTON ST
HOBBS NM
88240-8238
US

V. Phone/Fax

Practice location:
  • Phone: 575-393-0755
  • Fax:
Mailing address:
  • Phone: 575-393-0755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-08596
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: