Samantha Banda Palacios
Individual provider Active NPI Clinical Social Worker · Albuquerque, NM
NPI 1689370306 · NPPES record last updated Feb 3, 2023
Key facts
- NPI
- 1689370306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- M-11874 (NM)
- Practice address
- 3301 Candelaria Rd NE Ste B
Albuquerque, NM 87107-1965 - Phone
- (505) 273-6300
- NPI assigned
- Feb 3, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| M-11874 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Community Lighthouse | Past |
Accepting new patients | |
| The Community Lighthouse | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | M-11874 | NM | Yes |
Addresses
Primary practice location
3301 Candelaria Rd NE Ste B
Albuquerque, NM 87107-1965
Mailing address
3301 Candelaria Rd NE Ste B
Albuquerque, NM 87107-1965
Phone (505) 273-6300
Other providers in Albuquerque, NM
- Bethany Sue Balzis
- Abigail Bamberg
- Kyle Bamberg
- Sharon Lynn Bamberg
- Naomi Bancroft
- Gina Bandoni
- Michelle K Bane
- Douglas J Banegas Contreras
- Isaac Banegas
- Ann Banek
All providers in Albuquerque, 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 Feb 3, 2023. 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.