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NPI Code Detail

MEDICARE: MS. YESENIA ACOSTA LCSW

MEDICARE: MS. YESENIA ACOSTA LCSW
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
1104100000XSocial WorkerM-08383NM
21041C0700XClinical Social WorkerC-09180NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093152274
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. YESENIA ACOSTA LCSW
Provider Business Mailing Address
First Line : 385 CALLE DE ALEGRA STE A
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-3423
Country : US
Telephone Number : 575-526-1105
Fax Number : 575-524-4266
Provider Business Practice Location Address
First Line : 855 ANTHONY DR
Second Line :
City : ANTHONY
State : NM
Zip : 88021-9325
Country : US
Telephone Number : 575-882-5706
Fax Number : 575-882-2909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2013
Last Update Date : 12/12/2016

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Directions to “ MS. YESENIA ACOSTA LCSW” Practice Location

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