Provider Demographics
NPI:1841037348
Name:LORD, ADAM (P-LMSW)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:LORD
Suffix:
Gender:M
Credentials:P-LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 GALISTEO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2100
Mailing Address - Country:US
Mailing Address - Phone:505-500-9719
Mailing Address - Fax:
Practice Address - Street 1:2052 GALISTEO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2100
Practice Address - Country:US
Practice Address - Phone:505-500-9719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-01831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical