MEDICARE: VANESSA L GUALENI LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SWB-2025-0821	NM

General Provider Information

NPI Number	:	1073490454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA L GUALENI LMSW

Provider Business Mailing Address
First Line	:	1712 SINGLETARY DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-4842
Country	:	US
Telephone Number	:	505-818-8028
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 SILVER AVE SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-2856
Country	:	US
Telephone Number	:	505-292-6725
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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