Provider Demographics
NPI:1124178207
Name:SMAGA, SHARON GUZZETTI (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:GUZZETTI
Last Name:SMAGA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 PAJARITO DR
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-5544
Mailing Address - Country:US
Mailing Address - Phone:575-430-3701
Mailing Address - Fax:
Practice Address - Street 1:1212 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6343
Practice Address - Country:US
Practice Address - Phone:505-439-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0110501106H00000X
NM298452101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM50851233Medicaid