Provider Demographics
NPI:1245360908
Name:MACIEL, SANDEE ANN (LBSW)
Entity type:Individual
Prefix:MRS
First Name:SANDEE
Middle Name:ANN
Last Name:MACIEL
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 MANN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061
Mailing Address - Country:US
Mailing Address - Phone:575-956-2158
Mailing Address - Fax:575-388-2927
Practice Address - Street 1:2601 N SILVER ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-7206
Practice Address - Country:US
Practice Address - Phone:575-956-2158
Practice Address - Fax:575-388-2927
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMB059001041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool