Provider Demographics
NPI:1205562022
Name:KREBS, ERIN MEKENZIE (CSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MEKENZIE
Last Name:KREBS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MADISON ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6213
Mailing Address - Country:US
Mailing Address - Phone:505-307-6215
Mailing Address - Fax:
Practice Address - Street 1:3939 SAN PEDRO DR NE BLDG B1
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-8903
Practice Address - Country:US
Practice Address - Phone:505-903-5437
Practice Address - Fax:505-344-2104
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator