Provider Demographics
NPI:1609288711
Name:GARBERINA, WILLIAM LOUIS JR (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LOUIS
Last Name:GARBERINA
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:
Other - Last Name:GARBERINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9201 MONTGOMERY BLVD NE BLDG 5
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2468
Mailing Address - Country:US
Mailing Address - Phone:505-217-1717
Mailing Address - Fax:
Practice Address - Street 1:9201 MONTGOMERY BLVD NE BLDG 5
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2468
Practice Address - Country:US
Practice Address - Phone:505-620-6891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC095671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM39732754Medicaid