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NPI Code Detail

MEDICARE: MRS. SANTINA NICOLE SHIJE LMSW

MEDICARE: MRS. SANTINA NICOLE SHIJE 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
1101YM0800XMental Health CounselorM-09543NM

General Provider Information

NPI Number : 1518601962
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANTINA NICOLE SHIJE LMSW
Provider Business Mailing Address
First Line : 32 DEER TAIL RD
Second Line :
City : SANTA FE
State : NM
Zip : 87506-7272
Country : US
Telephone Number : 505-934-3201
Fax Number :
Provider Business Practice Location Address
First Line : 195 EAST RD STE 104
Second Line :
City : LOS ALAMOS
State : NM
Zip : 87544-4301
Country : US
Telephone Number : 505-412-7756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2022
Last Update Date : 04/22/2022

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