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General NPI Number Information
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NPI Number | 1851774426
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Entity Type | Organization
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Legal Business Name | SALLY JO WARNICK, LISW PSYCHOTHERAPY PRACTICE
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 25 NICKELL RD
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City | RANCHOS DE TAOS
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State | NM
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Zip | 87557-9709
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Country | US
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Telephone | 575-776-7432
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2629
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City | TAOS
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State | NM
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Zip | 87571-2629
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Country | US
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Telephone | 575-776-7432
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. SALLY JO WARNICK
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Credential | LISW
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Telephone | 575-776-7432
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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 | I-4486
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License Number State | NM
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