Provider Demographics
NPI:1801565445
Name:VEGA CHAVIRA, LIDIA M (LMSW)
Entity type:Individual
Prefix:
First Name:LIDIA
Middle Name:M
Last Name:VEGA CHAVIRA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N GRANT ST STE A
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-5134
Mailing Address - Country:US
Mailing Address - Phone:575-388-1447
Mailing Address - Fax:
Practice Address - Street 1:1311 N GRANT ST STE A
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-5134
Practice Address - Country:US
Practice Address - Phone:575-388-1447
Practice Address - Fax:575-388-1447
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0325101YA0400X
171M00000X
NMSWB-2025--1125104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator