Healthcare Provider Details

I. General information

NPI: 1063181584
Provider Name (Legal Business Name): ANGELA CAMILLE LUNA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. ANGELA CAMILLE VARELA

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 JUAN PEREA RD
LOS LUNAS NM
87031-7778
US

IV. Provider business mailing address

PO BOX 22242
SANTA FE NM
87502-2242
US

V. Phone/Fax

Practice location:
  • Phone: 505-886-7632
  • Fax:
Mailing address:
  • Phone: 505-570-0919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-1347
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number404323
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: