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General NPI Number Information
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NPI Number | 1215837091
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Entity Type | Organization
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Legal Business Name | TENELLE M PHILLIPS, LCSW LLC
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 705 S 5TH ST
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City | RATON
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State | NM
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Zip | 87740-4128
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Country | US
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Telephone | 575-447-0406
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Fax | 575-447-4750
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Provider Business Mailing Address
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Address Line | 705 S 5TH ST
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City | RATON
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State | NM
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Zip | 87740-4128
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Country | US
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Telephone | 575-447-0406
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Fax | 575-447-4750
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Authorized Official
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Title or Position | OWNER
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Name | TENELLE MARIE PHILLIPS
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Credential | LCSW
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Telephone | 575-447-0406
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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 |
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License Number State |
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