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General NPI Number Information
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NPI Number | 1376784629
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Entity Type | Individual
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Provider Name | VALERIE SHINESWARMLY PACINI LCSW/LISW
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Gender | Female
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 100 S AVENUE A STE B7
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City | PORTALES
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State | NM
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Zip | 88130-5917
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Country | US
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Telephone | 575-356-9884
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Fax | 575-356-9908
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Provider Business Mailing Address
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Address Line | PO BOX 626
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City | PORTALES
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State | NM
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Zip | 88130-0626
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Country | US
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Telephone | 575-356-9884
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Fax | 575-356-9908
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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-06954
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License Number State | NM
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