MEDICARE: JOANNE GALE EEKHOFF LISW

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	I-4030	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982696902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE GALE EEKHOFF LISW

Provider Business Mailing Address
First Line	:	PO BOX 4822
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87196-4822
Country	:	US
Telephone Number	:	505-417-5544
Fax Number	:	505-256-4188

Provider Business Practice Location Address
First Line	:	7521 SANTIAGO RD SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-7240
Country	:	US
Telephone Number	:	505-417-5544
Fax Number	:	505-256-4188

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	12/01/2023

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