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General NPI Number Information
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NPI Number | 1174262901
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Entity Type | Individual
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Provider Name | NATALIE THERESA CHAVEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 3736 EUBANK BLVD NE STE B1
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3583
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Country | US
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Telephone | 505-382-1578
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Fax | 888-506-2110
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Provider Business Mailing Address
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Address Line | 9531 VALLETTA AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2997
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Country | US
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Telephone | 505-489-2075
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-10508
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License Number State | NM
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