Provider Demographics
NPI:1508134511
Name:CHAVEZ, MONICA MARIE (PMSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 CENTRAL N.W.
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-2036
Mailing Address - Country:US
Mailing Address - Phone:505-831-6038
Mailing Address - Fax:
Practice Address - Street 1:6301 CENTRAL AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-2036
Practice Address - Country:US
Practice Address - Phone:505-831-6038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-073031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical