Provider Demographics
NPI:1174667687
Name:LUCERO-ESQUIVEL, PAULINE (MA, LPCC)
Entity Type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:
Last Name:LUCERO-ESQUIVEL
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 AVENIDA MANANA NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5748
Mailing Address - Country:US
Mailing Address - Phone:505-235-2429
Mailing Address - Fax:505-254-2294
Practice Address - Street 1:1401 AVENIDA MANANA NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5748
Practice Address - Country:US
Practice Address - Phone:505-235-2429
Practice Address - Fax:505-254-2294
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1840101YM0800X
NMM-08271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical