Vicki Fuller Allen, LISW
Individual provider Active NPI Clinical Social Worker · Lordsburg, NM
NPI 1912906322 · NPPES record last updated Mar 4, 2008
Key facts
- NPI
- 1912906322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I05940 (NM)
- Practice address
- 530 De Moss St
Hildago Medical Services
Lordsburg, NM 88045-2618 - Phone
- (575) 542-8384
- Fax
- (575) 542-8387
- NPI assigned
- Jul 18, 2005
- 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 |
|---|---|---|---|
| I05940 | NM | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I05940 | NM | Yes |
Addresses
Primary practice location
530 De Moss St
Hildago Medical Services
Lordsburg, NM 88045-2618
Mailing address
530 De Moss St
Lordsburg, NM 88045-2618
Phone (575) 542-8384
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49878531 | Medicaid | NM |
Other providers in Lordsburg, NM
- Abeyta Physical Therapy & Sports Medicine Inc
- Ruben Quintenar Abeyta Jr.
- Elsa Felecia Abrams
- Sabrina Knicole Aguilera
- At Park City
- Kerena Barron
- Marlene G. Baska
- Bestcare Pharmacy Lordsburg LLC
- Bootheel Youth Association
All providers in Lordsburg, 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 Mar 4, 2008. 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.