Basic Information
| Provider Information | |||||||||
| NPI: | 1700174984 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | CELESTE | ||||||||
| MiddleName: | NICOLE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1349 | ||||||||
| Address2: | |||||||||
| City: | SILVER CITY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880621349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753884497 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1318 E 32ND ST | ||||||||
| Address2: | |||||||||
| City: | SILVER CITY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880617252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753884412 | ||||||||
| FaxNumber: | 5755972809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2011 | ||||||||
| LastUpdateDate: | 07/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C-11271 | NM | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.