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General NPI Number Information
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NPI Number | 1174876296
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Entity Type | Individual
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Provider Name | AMANDA M LOBATO LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 475 E 20TH ST STE D
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City | FARMINGTON
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State | NM
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Zip | 87401-2151
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Country | US
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Telephone | 505-327-0293
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Fax |
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Provider Business Mailing Address
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Address Line | 108 N BEHREND AVE STE G
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City | FARMINGTON
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State | NM
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Zip | 87401-8418
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Country | US
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Telephone | 505-860-3479
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09928770
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-11390
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License Number State | NM
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