Provider Demographics
NPI:1811779812
Name:ORTIZ, DARLENE C (LMSW)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:C
Last Name:ORTIZ
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 1:755 S TELSHOR BLVD STE 203T
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8679
Mailing Address - Country:US
Mailing Address - Phone:575-647-1604
Mailing Address - Fax:575-647-9063
Practice Address - Street 1:755 S TELSHOR BLVD STE 203T
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8679
Practice Address - Country:US
Practice Address - Phone:575-647-1604
Practice Address - Fax:575-647-9063
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-098651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical