Judith Lee Shaw, LISW

Individual provider Active NPI Clinical Social Worker · El Rito, NM

NPI 1831341726 · NPPES record last updated Oct 22, 2008

Key facts

NPI
1831341726
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
I-06403 (NM)
Practice address
Hwy 571 BLDG #28
El Rito, NM 87530
Phone
(575) 581-4728
Fax
(575) 581-0030
NPI assigned
Oct 22, 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)
No

State licenses

LicenseStateTypeSpecialty
I-06403NMMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-06403 NM Yes

Addresses

Primary practice location

Hwy 571 BLDG #28
El Rito, NM 87530

Mailing address

686 Callecita Jicarilla
Santa Fe, NM 87505-4940
Phone (575) 581-4728

Other providers in El Rito, NM

All providers in El Rito, NM · Clinical Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.