Provider Demographics
NPI:1285321745
Name:NIETO, MEIGHEN (LMSW)
Entity type:Individual
Prefix:
First Name:MEIGHEN
Middle Name:
Last Name:NIETO
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 1:4321 FULCRUM WAY NE STE B
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-8410
Mailing Address - Country:US
Mailing Address - Phone:505-771-5371
Mailing Address - Fax:
Practice Address - Street 1:4321 FULCRUM WAY NE STE B
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-8410
Practice Address - Country:US
Practice Address - Phone:505-771-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2023-0142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health