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Individual

LEE ROY L LUCERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
8205 SPAIN RD NE STE 106, ALBUQUERQUE, NM 87109-3155
(505) 856-0300
Mailing address
8205 SPAIN RD NE STE 106, ALBUQUERQUE, NM 87109-3155

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CSA0207401
NM
104100000X
Social Worker
X-12018
NM
1041C0700X
Clinical Social Worker
Primary
SWB-2023-1197
NM

Other

Enumeration date
11/11/2019
Last updated
08/13/2024
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