Provider Demographics
NPI:1316531965
Name:CARA ORTEGA, LCSW, LLC
Entity type:Organization
Organization Name:CARA ORTEGA, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-557-5172
Mailing Address - Street 1:294 CAMINO VERDE
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA
Mailing Address - State:NM
Mailing Address - Zip Code:87731-2011
Mailing Address - Country:US
Mailing Address - Phone:505-557-5172
Mailing Address - Fax:
Practice Address - Street 1:294 CAMINO VERDE
Practice Address - Street 2:
Practice Address - City:MONTEZUMA
Practice Address - State:NM
Practice Address - Zip Code:87731-2011
Practice Address - Country:US
Practice Address - Phone:505-557-5172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty