Provider Demographics
NPI:1265139471
Name:HERRERA, CELINA DIANA (MSW, MPH, LMSW, CHES)
Entity type:Individual
Prefix:MS
First Name:CELINA
Middle Name:DIANA
Last Name:HERRERA
Suffix:
Gender:
Credentials:MSW, MPH, LMSW, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 SPRUCE ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-5226
Mailing Address - Country:US
Mailing Address - Phone:505-373-7820
Mailing Address - Fax:
Practice Address - Street 1:509 SPRUCE ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-5226
Practice Address - Country:US
Practice Address - Phone:505-373-7820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM34406174H00000X, 174H00000X
NMSWB-2024-09741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical