Healthcare Provider Details

I. General information

NPI: 1801698345
Provider Name (Legal Business Name): LMN COLLABORATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 CORTE PALOS SE
RIO RANCHO NM
87124-8839
US

IV. Provider business mailing address

10242 COORS BYP NW # 1044
ALBUQUERQUE NM
87114-4088
US

V. Phone/Fax

Practice location:
  • Phone: 610-416-9997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAURA NORDONE
Title or Position: OWNER
Credential: LCSW
Phone: 610-416-9997