Provider Demographics
NPI:1427359306
Name:ARAGON, LEON (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LEON
Middle Name:
Last Name:ARAGON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TESUQUE ST
Mailing Address - Street 2:
Mailing Address - City:KEWA
Mailing Address - State:NM
Mailing Address - Zip Code:87052-9998
Mailing Address - Country:US
Mailing Address - Phone:505-328-2737
Mailing Address - Fax:505-465-0433
Practice Address - Street 1:10 TESUQUE ST
Practice Address - Street 2:
Practice Address - City:KEWA
Practice Address - State:NM
Practice Address - Zip Code:87052-9998
Practice Address - Country:US
Practice Address - Phone:505-328-2737
Practice Address - Fax:505-465-0433
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-089781041C0700X
NMM-07587104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical