Deanna Devore, LMSW
Individual provider Active NPI Social Worker · Bloomfield, NM
NPI 1437134046 · NPPES record last updated Mar 9, 2011
Key facts
- NPI
- 1437134046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- M4096 (AZ)
- Practice address
- 6 Road 7586
Bloomfield, NM 87413-4934 - Phone
- (505) 368-8100
- Fax
- (505) 368-8028
- NPI assigned
- Dec 7, 2005
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M4096 | AZ | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M4096 | AZ | Yes |
Addresses
Primary practice location
6 Road 7586
Bloomfield, NM 87413-4934
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-8100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39506878 | Medicaid | NM |
Other providers in Bloomfield, NM
- Telecia Crockett
- Anna Marie Curtis
- Kellen Dean
- Karen Dennis
- Nicole Marie Desouchet
- DHHS PHS Naihs Shiprock Hospital
- DHHS PHS Naihs Shiprock Hospital
- DHHS PHS Naihs Shiprock Hospital
- DHHS, PHS, Naihs, Shiprock Hospital
- DHHS, PHS, Naihs, Shiprock Hospital
All providers in Bloomfield, NM · 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 Mar 9, 2011. 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.