Provider Demographics
NPI:1306172200
Name:STROKA, CINDY LOUISE
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:LOUISE
Last Name:STROKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 SAN MATEO BLVD NE
Mailing Address - Street 2:SUITE S-10
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4058
Mailing Address - Country:US
Mailing Address - Phone:505-830-6500
Mailing Address - Fax:505-830-6527
Practice Address - Street 1:2403 SAN MATEO BLVD NE
Practice Address - Street 2:SUITE S-10
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4058
Practice Address - Country:US
Practice Address - Phone:505-830-6500
Practice Address - Fax:505-830-6527
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0110641101YA0400X
NMM-059721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)