Judith Balderrama-Lovato, LCSW
Individual provider Active NPI Clinical Social Worker · Kirtland Afb, NM
NPI 1902149677 · NPPES record last updated Sep 20, 2023
Key facts
- NPI
- 1902149677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SWB-2022-0044 (NM)
- Practice address
- 2050A 2ND St SE
Kirtland Afb, NM 87117-2706 - Phone
- (505) 846-3322
- NPI assigned
- Apr 1, 2013
- 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 |
|---|---|---|---|
| SWB-2022-0044 | NM | MD | Clinical Social Worker |
| X-07932 | NM | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | X-07932 | NM | |
| Clinical Social Worker | 1041C0700X | SWB-2022-0044 | NM | Yes |
Addresses
Primary practice location
2050A 2ND St SE
Kirtland Afb, NM 87117-2706
Mailing address
1501 San Pedro Dr SE
Kirtland Afb, NM 87108-5153
Phone (505) 846-3322
Other providers in Kirtland Afb, NM
- Ubong Ime Akpan
- Jay Ronald Allen
- Paige Loreen Andre-Hudson
- Becky Azama
- Rebecca Yael Bak
- M. Melisse Barlow
- Laura M Baugh
- Morgan Bergman
- James Curtis Bloom
- Chadwyck R Bradley
All providers in Kirtland Afb, 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 Sep 20, 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.