Provider Demographics
NPI:1871079798
Name:ESPINOSA, KARRIE (LMSW)
Entity type:Individual
Prefix:
First Name:KARRIE
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W COURT AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2596
Mailing Address - Country:US
Mailing Address - Phone:575-652-4006
Mailing Address - Fax:
Practice Address - Street 1:402 W COURT AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2596
Practice Address - Country:US
Practice Address - Phone:575-652-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-104471041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool