Healthcare Provider Details

I. General information

NPI: 1790405074
Provider Name (Legal Business Name): SPRING COFFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 YUCCA ST
SANTA FE NM
87505-5456
US

IV. Provider business mailing address

6000 WOODFORD PL NE
ALBUQUERQUE NM
87110-1232
US

V. Phone/Fax

Practice location:
  • Phone: 505-467-2400
  • Fax:
Mailing address:
  • Phone: 505-917-4931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberSWB-2023-0194
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2023-0194
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: