Yesenia Acosta, LCSW
Individual provider Active NPI Clinical Social Worker · Anthony, NM
NPI 1093152274 · NPPES record last updated Dec 12, 2016
Key facts
- NPI
- 1093152274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C-09180 (NM)
- Practice address
- 855 Anthony Dr
Anthony, NM 88021-9325 - Phone
- (575) 882-5706
- Fax
- (575) 882-2909
- NPI assigned
- May 29, 2013
- 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 |
|---|---|---|---|
| M-08383 | NM | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M-08383 | NM | |
| Clinical Social Worker | 1041C0700X | C-09180 | NM | Yes |
Addresses
Primary practice location
855 Anthony Dr
Anthony, NM 88021-9325
Mailing address
385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18677037 | Medicaid | NM |
Other providers in Anthony, NM
- 21St Century Care, LLC
- Abanza Pesonal Care Services II LLC
- Donna Lynn Abeyta
- Karina Acosta Larios
- Valerie W Acosta
- Adl Counseling LLC
- Eva Pavia Aguilar
- Maria Sharlene Aguilar
- Michelle Aguirre Soto
- Bianca Al-Tahan
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 Dec 12, 2016. 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.