Provider Demographics
NPI:1174690234
Name:MCGUIRE WESTBY, M CANDIS (LISW LCSW ACSW)
Entity Type:Individual
Prefix:MS
First Name:M
Middle Name:CANDIS
Last Name:MCGUIRE WESTBY
Suffix:
Gender:F
Credentials:LISW LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 VISTA MONTANA LOOP
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043
Mailing Address - Country:US
Mailing Address - Phone:505-269-7516
Mailing Address - Fax:505-867-5399
Practice Address - Street 1:102 VISTA MONTANA LOOP
Practice Address - Street 2:
Practice Address - City:PLACITAS
Practice Address - State:NM
Practice Address - Zip Code:87043
Practice Address - Country:US
Practice Address - Phone:505-269-7516
Practice Address - Fax:505-867-5399
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNMI0122104100000X
CALCS13400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMI-0122OtherVALUE OPTIONS
NM00096835Medicaid