Lori Anne Vallejos, LCSW
Individual provider Active NPI Clinical Social Worker · Laguna, NM
NPI 1902440191 · NPPES record last updated Oct 31, 2019
Key facts
- NPI
- 1902440191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C-11015 (NM)
- Practice address
- 7 Rio San Jose
Laguna, NM 87026 - Phone
- (505) 552-5730
- NPI assigned
- Oct 31, 2019
- 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 |
|---|---|---|---|
| C-11015 | NM | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-11015 | NM | Yes |
Addresses
Primary practice location
7 Rio San Jose
Laguna, NM 87026
Mailing address
7 Rio San Jose
Laguna, NM 87026
Phone (505) 552-5730
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106278130 | Other | NM | NM DRIVERS LICENSE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lvallejos@pol-nsn.gov | Direct |
Other providers in Laguna, NM
All providers in Laguna, 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 31, 2019. 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.