Healthcare Provider Details

I. General information

NPI: 1700174984
Provider Name (Legal Business Name): CELESTE NICOLE MORALES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 E 32ND ST
SILVER CITY NM
88061-7252
US

IV. Provider business mailing address

PO BOX 1349
SILVER CITY NM
88062-1349
US

V. Phone/Fax

Practice location:
  • Phone: 575-388-4412
  • Fax: 575-597-2809
Mailing address:
  • Phone: 575-388-4497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-11271
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: