MEDICARE: NATALIE DE SANTIAGO 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	172V00000X	Community Health Worker
2	104100000X	Social Worker	SWB-2025-0632	NM

General Provider Information

NPI Number	:	1184284242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE DE SANTIAGO LMSW

Provider Business Mailing Address
First Line	:	2521 SAN PEDRO DR NE STE F
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4118
Country	:	US
Telephone Number	:	505-974-2834
Fax Number	:

Provider Business Practice Location Address
First Line	:	2521 SAN PEDRO DR NE STE F
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4118
Country	:	US
Telephone Number	:	505-974-2834
Fax Number	:

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

Provider Enumeration Date	:	06/19/2019
Last Update Date	:	06/30/2025

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