| Elise Hensley, Lisw, Inc. | |
|
02 Hormiga Ct. Los Lunas NM 87031-3319 | |
| (505) 270-8778 | |
| Not Available |
| Full Name | Elise Hensley, Lisw, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 02 Hormiga Ct., Los Lunas, New Mexico |
| Authorized Official Name and Position | Elise Hensley (PRESIDENT) |
| Authorized Official Contact | 5052708778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elise Hensley, Lisw, Inc. 02 Hormiga Ct. P. O. Box 3319 Los Lunas NM 87031-3319 Ph: (505) 270-8778 | Elise Hensley, Lisw, Inc. 02 Hormiga Ct. Los Lunas NM 87031-3319 Ph: (505) 270-8778 |
| NPI Number | 1659782191 |
|---|---|
| Provider Enumeration Date | 05/19/2014 |
| Last Update Date | 05/22/2014 |
| Medicare PECOS PAC ID | 3476945775 |
|---|---|
| Medicare Enrollment ID | O20220119000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659782191 | NPI | - | NPPES |
| 81202229 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-04788 (New Mexico) | Primary |
| Provider Name | Elise Hensley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194736223 PECOS PAC ID: 4385036680 Enrollment ID: I20220119000185 |
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