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NPI Code Detail

MEDICARE: NATALIE THERESA CHAVEZ LCSW

MEDICARE: NATALIE THERESA CHAVEZ 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
11041C0700XClinical Social WorkerC-10508NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C-10508OTHERNMSTATE LICENSE

General Provider Information

NPI Number : 1174262901
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE THERESA CHAVEZ LCSW
Provider Business Mailing Address
First Line : 9531 VALLETTA AVE NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-2997
Country : US
Telephone Number : 505-489-2075
Fax Number :
Provider Business Practice Location Address
First Line : 3736 EUBANK BLVD NE STE B1
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-3583
Country : US
Telephone Number : 505-382-1578
Fax Number : 888-506-2110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2022
Last Update Date : 05/31/2022

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