Desiree Bustos, CPSW
Individual provider Active NPI Counselor · Espanola, NM
NPI 1144944315 · NPPES record last updated Sep 30, 2022
Key facts
- NPI
- 1144944315
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 1409 (NM)
- Practice address
- 2010 Industrial Park Rd
Espanola, NM 87532-3600 - Phone
- (505) 753-7396
- NPI assigned
- Sep 30, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 1409 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| El Centro Family Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1409 | NM | Yes |
Addresses
Primary practice location
2010 Industrial Park Rd
Espanola, NM 87532-3600
Mailing address
538 N Paseo de Onate
Espanola, NM 87532-2618
Phone (505) 753-7218
Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2022. 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.