Provider Demographics
NPI:1154622488
Name:PINON, VERONICA L (LMSW)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:L
Last Name:PINON
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 1:6621 DONIPHAN DR STE G
Mailing Address - Street 2:
Mailing Address - City:CANUTILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79835-5005
Mailing Address - Country:US
Mailing Address - Phone:915-877-5100
Mailing Address - Fax:915-877-5107
Practice Address - Street 1:6621 DONIPHAN DR STE G
Practice Address - Street 2:
Practice Address - City:CANUTILLO
Practice Address - State:TX
Practice Address - Zip Code:79835-5005
Practice Address - Country:US
Practice Address - Phone:915-877-5100
Practice Address - Fax:915-877-5107
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX07181104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM64153274Medicaid