Yvette Gonzales, LBSW

Individual provider Active NPI School Social Worker · Bayard, NM

NPI 1962825018 · NPPES record last updated Jan 27, 2014

Key facts

NPI
1962825018
Entity type
Individual (NPI type 1)
Primary specialty
School Social Worker 1041S0200X
License
B-3973 (NM)
Practice address
900 Central Ave
Bayard, NM 88023
Phone
(575) 537-4000
Fax
(575) 537-3921
NPI assigned
Jan 27, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
B-3973NMMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cobre Consolidated Schools Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X B-3973 NM Yes

Addresses

Primary practice location

900 Central Ave
Bayard, NM 88023

Mailing address

900 Central Ave
Bayard, NM 88023
Phone (575) 537-4000

Other identifiers

IdentifierTypeStateIssuer
000L1871MedicaidNM

Other providers in Bayard, NM

All providers in Bayard, NM · School Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.