Provider Demographics
NPI:1215201991
Name:CORAZON TRAINING AND CONSULTING INC
Entity Type:Organization
Organization Name:CORAZON TRAINING AND CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCERO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMSW, LPCC
Authorized Official - Phone:505-235-2429
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM18401041C0700X
NMM-08271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM79128025Medicaid