Provider Demographics
NPI:1154649952
Name:KHALSA, SATSANGEET KAUR (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SATSANGEET
Middle Name:KAUR
Last Name:KHALSA
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 1:1302 CALLE DE LA MERCED
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-2624
Mailing Address - Country:US
Mailing Address - Phone:505-747-0811
Mailing Address - Fax:
Practice Address - Street 1:1302 CALLE DE LA MERCED
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-1302
Practice Address - Country:US
Practice Address - Phone:505-747-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-076481041C0700X
NMM-06690104100000X
NMI-076481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker