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General NPI Number Information
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NPI Number | 1265705586
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Entity Type | Individual
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Provider Name | NATASHA LEE MCCANTS LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 2573 STATE HIGHWAY 522
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City | QUESTA
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State | NM
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Zip | 87556-0290
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Country | US
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Telephone | 575-586-0331
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Fax |
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Provider Business Mailing Address
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Address Line | 2573 STATE HIGHWAY 522
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City | QUESTA
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State | NM
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Zip | 87556-0290
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Country | US
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Telephone | 505-586-0331
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Fax | 575-586-0519
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | M-09115
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License Number State | NM
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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 | C-10704
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License Number State | NM
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