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General NPI Number Information
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NPI Number | 1558221879
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Entity Type | Organization
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Legal Business Name | LISA KOFFMAN LCSW
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1021 CARLISLE BLVD SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1642
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Country | US
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Telephone | 505-908-1540
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Fax |
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Provider Business Mailing Address
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Address Line | 1812 MORNINGRISE PL SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-4520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | LISA ANN KOFFMAN
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Credential | LCSW
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Telephone | 505-908-1540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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