Provider Demographics
NPI:1801977491
Name:FLORES, CARLOS M (MSW)
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:M
Last Name:FLORES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5829 PAULINE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-5326
Mailing Address - Country:US
Mailing Address - Phone:505-344-1797
Mailing Address - Fax:505-344-1797
Practice Address - Street 1:5829 PAULINE AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-5326
Practice Address - Country:US
Practice Address - Phone:505-344-1797
Practice Address - Fax:505-344-1797
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3802101YA0400X
NMM-3152101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health