Healthcare Provider Details

I. General information

NPI: 1053595140
Provider Name (Legal Business Name): GENIE HOBBS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 ARTIST RD #314
SANTE FE NM
87501-8750
US

IV. Provider business mailing address

518 OLD SANTA FE TRAIL, STE 1 #314
SANTA FE NM
87505-1307
US

V. Phone/Fax

Practice location:
  • Phone: 720-255-4542
  • Fax:
Mailing address:
  • Phone: 720-255-4542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number844
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2023-0281
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: