Patricia Serna, LISW

Individual provider Active NPI Clinical Social Worker · Chama, NM

NPI 1073820122 · NPPES record last updated Sep 10, 2010

Key facts

NPI
1073820122
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
I-0175 (NM)
Practice address
16542 Hwy 84
Chama, NM 87520-0617
Phone
(575) 756-2327
Fax
(575) 756-1897
NPI assigned
Sep 10, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
I-0175NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Community Based Services, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0175 NM Yes

Addresses

Primary practice location

16542 Hwy 84
Chama, NM 87520-0617

Mailing address

PO Box 617
Chama, NM 87520-0617
Phone (575) 756-2327

Other providers in Chama, NM

All providers in Chama, NM · Clinical Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.