Elia Jacqueline Flores, BSW
Individual provider Active NPI Clinical Social Worker · Anthony, NM
NPI 1023292745 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1023292745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SWB-2022-0850 (NM)
- Practice address
- 1325 Washington St
Anthony, NM 88021-8846 - Phone
- (575) 882-6101
- NPI assigned
- Dec 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0109051 | NM | MD | Addiction (Substance Use Disorder) Counselor |
| SWB-2022-0850 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern New Mexico Human Development, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0109051 | NM | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Clinical Social Worker | 1041C0700X | SWB-2022-0850 | NM | Yes |
Addresses
Primary practice location
1325 Washington St
Anthony, NM 88021-8846
Mailing address
1325 Washington St
Anthony, NM 88021-8846
Phone (575) 882-6101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VNM30451NI | Medicaid | NM |
Other providers in Anthony, NM
- Yvette Espinoza
- Virginia Estala
- Stephanie Fallert
- Familia Care
- Family Medicine and Rejuvenation Therapies
- Jose Leos Flores
- Michael Keith Ford
- Emilia Isabel Franco
- Victoria Louise Fresquez
- Stephanie Frietze
All providers in Anthony, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.