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1719 Vasilion Pl Nw Albuquerque NM 87120-6177 | |
| (505) 920-6387 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 1719 Vasilion Pl Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Leticia Molina Landeros (LCSW, OUTPATIENT CLINICAL THERAPIST) |
| Authorized Official Contact | 5059206387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1719 Vasilion Pl Nw Albuquerque NM 87120-6177 Ph: (505) 920-6387 | 1719 Vasilion Pl Nw Albuquerque NM 87120-6177 Ph: (505) 920-6387 |
| NPI Number | 1528801289 |
|---|---|
| Provider Enumeration Date | 06/18/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 7113464702 |
|---|---|
| Medicare Enrollment ID | O20240731003422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528801289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leticia Molina-landeros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861804031 PECOS PAC ID: 1153761275 Enrollment ID: I20240506003421 |
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