Provider Demographics
NPI:1558783506
Name:MCCASH, CONSUELO L (LMSW)
Entity Type:Individual
Prefix:
First Name:CONSUELO
Middle Name:L
Last Name:MCCASH
Suffix:
Gender:F
Credentials:LMSW
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 10055
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87184-0055
Mailing Address - Country:US
Mailing Address - Phone:505-614-7403
Mailing Address - Fax:505-212-4342
Practice Address - Street 1:5931 JEFFERSON ST NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3408
Practice Address - Country:US
Practice Address - Phone:505-614-7403
Practice Address - Fax:505-212-4342
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-083781041C0700X
NMC094901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical