Provider Demographics
NPI:1467581017
Name:SALAZAR, LUCIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CAMINO SIERRA VISTA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505
Mailing Address - Country:US
Mailing Address - Phone:505-467-1072
Mailing Address - Fax:
Practice Address - Street 1:3200 32ND STREET BYP
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-7802
Practice Address - Country:US
Practice Address - Phone:575-597-2650
Practice Address - Fax:575-597-2651
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-053501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM23236868Medicaid