MEDICARE: MRS. DANIELLE MARIE GUERRERO 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
1	1041C0700X	Clinical Social Worker	C-11364	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C-11364	OTHER	NM	STATE OF NEW MEXICO

General Provider Information

NPI Number	:	1679851000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE MARIE GUERRERO LCSW

Provider Business Mailing Address
First Line	:	7509 SIERRA DE ORO PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-0794
Country	:	US
Telephone Number	:	575-635-5985
Fax Number	:

Provider Business Practice Location Address
First Line	:	7509 SIERRA DE ORO PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-0794
Country	:	US
Telephone Number	:	575-635-5985
Fax Number	:

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

Provider Enumeration Date	:	08/03/2011
Last Update Date	:	07/16/2024

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