MEDICARE: CHRISTI MICHELLE FIELDS 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	LCSW94854	CA
2	1041C0700X	Clinical Social Worker	C-11005	NM

General Provider Information

NPI Number	:	1891331880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTI MICHELLE FIELDS LCSW

Provider Business Mailing Address
First Line	:	800 LOMA LINDA PL SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-3345
Country	:	US
Telephone Number	:	505-604-0221
Fax Number	:	505-448-7884

Provider Business Practice Location Address
First Line	:	2900 LOUISIANA BLVD NE STE A2
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-3550
Country	:	US
Telephone Number	:	505-604-0221
Fax Number	:	505-448-7884

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

Provider Enumeration Date	:	11/25/2019
Last Update Date	:	04/03/2025

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