Provider Demographics
NPI:1053503250
Name:ORTEGA, CARA A (LCSW)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:A
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 33 BOX 78
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA
Mailing Address - State:NM
Mailing Address - Zip Code:87731-0349
Mailing Address - Country:US
Mailing Address - Phone:505-557-5172
Mailing Address - Fax:
Practice Address - Street 1:294 CAMINO VERDE
Practice Address - Street 2:
Practice Address - City:MONTEZUMA
Practice Address - State:NM
Practice Address - Zip Code:87731-2011
Practice Address - Country:US
Practice Address - Phone:505-557-5172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-071131041C0700X
NMI-07113104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical