Provider Demographics
NPI:1467774885
Name:MUTERPERL, SCHIA (LMSW, LPCC)
Entity Type:Individual
Prefix:
First Name:SCHIA
Middle Name:
Last Name:MUTERPERL
Suffix:
Gender:M
Credentials:LMSW, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3157
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87533-3157
Mailing Address - Country:US
Mailing Address - Phone:505-747-1991
Mailing Address - Fax:
Practice Address - Street 1:904 E FAIRVIEW LN
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2822
Practice Address - Country:US
Practice Address - Phone:505-747-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-1882104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker