MEDICARE: LASHANAH DAWN BENALLY 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	104100000X	Social Worker	SWB-2026-0195	NM

General Provider Information

NPI Number	:	1952137655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHANAH DAWN BENALLY LMSW

Provider Business Mailing Address
First Line	:	835 SPRUCE ST
Second Line	:
City	:	ESPANOLA
State	:	NM
Zip	:	87532-3455
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	835 SPRUCE ST
Second Line	:
City	:	ESPANOLA
State	:	NM
Zip	:	87532-3455
Country	:	US
Telephone Number	:	505-443-2800
Fax Number	:

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

Provider Enumeration Date	:	09/10/2024
Last Update Date	:	02/20/2026

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