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General NPI Number Information
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NPI Number | 1639618952
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Entity Type | Individual
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Provider Name | MICHELLE ADAMS MCDANIEL LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 2 MORGAN RD
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City | BELEN
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State | NM
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Zip | 87002-7076
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Country | US
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Telephone | 505-818-8253
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Fax | 505-521-5150
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Provider Business Mailing Address
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Address Line | 2 MORGAN RD
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City | BELEN
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State | NM
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Zip | 87002-7076
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Country | US
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Telephone | 505-818-8253
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Fax | 505-521-5150
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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 | M-09198
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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-10243
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License Number State | NM
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