Healthcare Provider Details

I. General information

NPI: 1740192756
Provider Name (Legal Business Name): CASSANDRA JOY CABRERA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2939 LOS AMIGOS CT
LAS CRUCES NM
88011-4836
US

IV. Provider business mailing address

14536 PETRALIA AVE
EL PASO TX
79938-2334
US

V. Phone/Fax

Practice location:
  • Phone: 575-210-5990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-1261
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: