Provider Demographics
NPI:1194859330
Name:HERRERA-SPINELLI, SANDRA Y (LISW, DSW)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:Y
Last Name:HERRERA-SPINELLI
Suffix:
Gender:F
Credentials:LISW, DSW
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:Y
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:PO BOX 66255
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87193-6255
Mailing Address - Country:US
Mailing Address - Phone:505-459-0025
Mailing Address - Fax:505-899-8372
Practice Address - Street 1:10052 COORS BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4020
Practice Address - Country:US
Practice Address - Phone:505-459-0025
Practice Address - Fax:505-899-8372
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-060771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM47524715Medicaid