Provider Demographics
NPI:1225740640
Name:SERRANO, KELSI LENAE (LCSW)
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:LENAE
Last Name:SERRANO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 ZIMMERMAN AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5926
Mailing Address - Country:US
Mailing Address - Phone:505-221-6421
Mailing Address - Fax:
Practice Address - Street 1:6213 ZIMMERMAN AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5926
Practice Address - Country:US
Practice Address - Phone:505-221-6421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2022-0780104100000X
NMSWB-2025-00061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker