Provider Demographics
NPI:1164079570
Name:ALBERT, MARGARET (CPSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:CPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1755
Mailing Address - Street 2:
Mailing Address - City:RATON
Mailing Address - State:NM
Mailing Address - Zip Code:87740-1755
Mailing Address - Country:US
Mailing Address - Phone:575-707-3492
Mailing Address - Fax:575-707-3492
Practice Address - Street 1:124 S 3RD ST
Practice Address - Street 2:
Practice Address - City:RATON
Practice Address - State:NM
Practice Address - Zip Code:87740-3910
Practice Address - Country:US
Practice Address - Phone:575-707-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA172V00000X
NM841175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM841OtherBEHAVIORAL HEALTH CREDENTIALING BOARD