Provider Demographics
NPI:1184284242
Name:DE SANTIAGO, NATALIE (LMSW)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:DE SANTIAGO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2521 SAN PEDRO DR NE STE F
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4118
Mailing Address - Country:US
Mailing Address - Phone:505-974-2834
Mailing Address - Fax:
Practice Address - Street 1:2521 SAN PEDRO DR NE STE F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4118
Practice Address - Country:US
Practice Address - Phone:505-974-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
NMSWB-2025-0632104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172V00000XOther Service ProvidersCommunity Health Worker