Provider Demographics
NPI:1629548847
Name:SALGADO, IRMA JESSICA (LCSW)
Entity Type:Individual
Prefix:
First Name:IRMA
Middle Name:JESSICA
Last Name:SALGADO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:SALGADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:9180 COORS BLVD NW APT 2905
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3122
Mailing Address - Country:US
Mailing Address - Phone:505-929-9224
Mailing Address - Fax:
Practice Address - Street 1:9180 COORS BLVD NW APT 2905
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-3122
Practice Address - Country:US
Practice Address - Phone:505-929-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-119091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical