Twila Becenti-Fundark, LISW
Individual provider Active NPI Clinical Social Worker · Farmington, NM
NPI 1710136726 · NPPES record last updated Oct 14, 2011
Key facts
- NPI
- 1710136726
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I-4224 (NM)
- Practice address
- 355 S. Miller
Farmington, NM 87401-5617 - Phone
- (505) 566-0515
- NPI assigned
- Sep 15, 2008
- 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 |
|---|---|---|---|
| I-4224 | NM | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-4224 | NM | Yes |
Addresses
Primary practice location
355 S. Miller
Farmington, NM 87401-5617
Mailing address
355 S Miller Ave
Farmington, NM 87401-6463
Other providers in Farmington, NM
- Theresa Beach
- Morgan Beasley
- Janice C Beatty
- Aaron Beauford
- Alex Harley Beauford
- Diandra Coral Becenti
- Onshai Becenti
- C. Michael Beck
- Judy K Beck
- Shay Beck
All providers in Farmington, 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 Oct 14, 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.