Provider Demographics
NPI:1770033938
Name:HERRING, CHRISSY MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISSY
Middle Name:MARIE
Last Name:HERRING
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 PAN AMERICAN FWY NE UNIT 110
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1826
Mailing Address - Country:US
Mailing Address - Phone:505-990-9945
Mailing Address - Fax:
Practice Address - Street 1:5310 SEQUOIA RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1249
Practice Address - Country:US
Practice Address - Phone:505-352-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-096051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical