Healthcare Provider Details

I. General information

NPI: 1689446734
Provider Name (Legal Business Name): EVELINA CAVALLI-MURRAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 AVE VISTA GRANDE STE B7
SANTA FE NM
87508-9207
US

IV. Provider business mailing address

7 AVE VISTA GRANDE STE B7
SANTA FE NM
87508-9207
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-7063
  • Fax:
Mailing address:
  • Phone: 505-913-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-1380
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: