Provider Demographics
NPI:1497089452
Name:GRIEGO PENNY, VALERIE DIANNE (LMSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:DIANNE
Last Name:GRIEGO PENNY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DIANNE
Other - Last Name:GRIEGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:601 FOUR HILLS RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-4100
Mailing Address - Country:US
Mailing Address - Phone:407-924-2874
Mailing Address - Fax:
Practice Address - Street 1:4055 MONTGOMERY BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1179
Practice Address - Country:US
Practice Address - Phone:505-884-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker