Provider Demographics
NPI:1720688609
Name:NOTOR HUGHES, LORI RAE (LCSW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:RAE
Last Name:NOTOR HUGHES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E 20TH ST #5526
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-7185
Mailing Address - Country:US
Mailing Address - Phone:505-513-9834
Mailing Address - Fax:505-325-4323
Practice Address - Street 1:2120 SULLIVAN AVE #25
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-4324
Practice Address - Country:US
Practice Address - Phone:505-513-9834
Practice Address - Fax:505-325-4323
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099288561041C0700X
NMSWB-2022-11381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM91626315Medicaid