Provider Demographics
NPI:1750561551
Name:SALINGER, EYTAN S (LCSW)
Entity type:Individual
Prefix:MR
First Name:EYTAN
Middle Name:S
Last Name:SALINGER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2805 LAS VEGAS CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-4108
Mailing Address - Country:US
Mailing Address - Phone:575-522-5144
Mailing Address - Fax:575-522-5177
Practice Address - Street 1:2805 LAS VEGAS CT
Practice Address - Street 2:SUITE B
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-4108
Practice Address - Country:US
Practice Address - Phone:575-522-5144
Practice Address - Fax:575-522-5177
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-088641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM18677037Medicaid