Individual
WILLIAM JACOB DIVETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1010 LAS LOMAS RD NE, ALBUQUERQUE, NM 87102-2634
(505) 246-8700
Mailing address
1010 LAS LOMAS RD NE, ALBUQUERQUE, NM 87102-2634
(505) 246-8700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C08039
NM
104100000X
Social Worker
Primary
I08039
NM
Other
Enumeration date
08/16/2012
Last updated
02/06/2026
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