Judith Acosta, LISW LCSW
Individual provider Active NPI Clinical Social Worker · Placitas, NM
NPI 1043380041 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043380041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I06292 (NM)
- Practice address
- 16 Roadrunner Trail
Placitas, NM 87043 - Phone
- (505) 771-2282
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I06292 | NM | MD | Clinical Social Worker |
| 0421371 | NY | MD | Clinical Social Worker |
| 042137 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I06292 | NM | Yes |
| Clinical Social Worker | 1041C0700X | 0421371 | NY |
Addresses
Primary practice location
16 Roadrunner Trail
Placitas, NM 87043
Mailing address
16 Roadrunner Trail
Placitas, NM 87043
Phone (505) 771-2282
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160289 | Other | NM | GHI |
| 160289 | Other | NY | VALUE OPTIONS |
Other providers in Placitas, NM
- Erika Anne Aberg
- Acceptance & Change Therapy
- Annette Vignogna Browne, GNP, LLC
- Becoming Well, LLC
- Beyond Words, LLC
- Blue Sky Therapeutic Services Inc.
- Laura Faye Burton
All providers in Placitas, 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 Jul 8, 2007. 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.