Healthcare Provider Details

I. General information

NPI: 1659335990
Provider Name (Legal Business Name): RUSSELL A SCHWEIGER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5312 RIO BRAVO DR STE 10
SANTA TERESA NM
88008-9210
US

IV. Provider business mailing address

PO BOX 264
LAS CRUCES NM
88004-0264
US

V. Phone/Fax

Practice location:
  • Phone: 575-915-1338
  • Fax: 575-915-1819
Mailing address:
  • Phone: 915-549-3968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI05690
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: