Didi Marie Josea, LMSW

Individual provider Active NPI Clinical Social Worker · Ganado, AZ

NPI 1780113340 · NPPES record last updated Jul 5, 2019

Key facts

NPI
1780113340
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
M-10119 (NM)
Practice address
3.7 Miles SE of MP 455 Hwy 264
Ganado, AZ 86505
Phone
(928) 729-4012
NPI assigned
Jun 7, 2017
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

LicenseStateTypeSpecialty
X-10068NMMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X X-10068 NM
Clinical Social Worker 1041C0700X M-10119 NM Yes

Addresses

Primary practice location

3.7 Miles SE of MP 455 Hwy 264
Ganado, AZ 86505

Mailing address

PO Box 921
Saint Michaels, AZ 86511-0921
Phone (928) 856-4338

Other providers in Ganado, AZ

All providers in Ganado, AZ · Clinical Social Worker in Arizona

Sources for this page

Verify at the official NPI Registry.