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General NPI Number Information
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NPI Number | 1588397871
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Entity Type | Individual
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Provider Name | KATHERINE IRENE CONVERY LSAA, LMSW-P
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Gender | Female
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1007 N POPE ST
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City | SILVER CITY
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State | NM
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Zip | 88061-5161
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Country | US
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Telephone | 575-800-1467
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Fax | 575-313-8236
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Provider Business Mailing Address
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Address Line | 530 DEMOSS ST.
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City | LORDSBURG
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State | NM
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Zip | 88045
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Country | US
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Telephone | 575-800-1467
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Fax | 575-313-8235
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CTB-2022-0252
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWB-2025-0066
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License Number State | NM
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