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General NPI Number Information
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NPI Number | 1467953570
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Entity Type | Individual
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Provider Name | INGRID LUCIA BISBEE LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 901 RIO GRANDE BLVD NW STE G252
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2059
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Country | US
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Telephone | 505-249-2798
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Fax | 505-254-9911
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Provider Business Mailing Address
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Address Line | 901 RIO GRANDE BLVD NW STE G252
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2059
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Country | US
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Telephone | 57-028-1125
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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-11350
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License Number State | NM
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