Healthcare Provider Details
I. General information
NPI: 1679414619
Provider Name (Legal Business Name): LEA MARIE PRITCHET CPSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 N ALAMEDA BLVD
LAS CRUCES NM
88005-2590
US
IV. Provider business mailing address
303 N ALAMEDA BLVD
LAS CRUCES NM
88005-2590
US
V. Phone/Fax
- Phone: 575-523-0111
- Fax: 575-571-4031
- Phone: 575-523-0111
- Fax: 575-571-4031
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | 2011 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: