Provider Demographics
NPI:1679851000
Name:GUERRERO, DANIELLE MARIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE
Last Name:GUERRERO
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 1:1065 S MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2909
Mailing Address - Country:US
Mailing Address - Phone:575-652-3135
Mailing Address - Fax:505-237-0068
Practice Address - Street 1:1065 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2909
Practice Address - Country:US
Practice Address - Phone:575-652-3135
Practice Address - Fax:505-237-0068
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-099881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMM-09988OtherSTATE LICENSE
NM18677037Medicaid