Provider Demographics
NPI:1417458746
Name:RUBIO, ALEXANDRIA N (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:N
Last Name:RUBIO
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 1:4010 CARLISLE N.E
Mailing Address - Street 2:SUITE F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6929
Mailing Address - Country:US
Mailing Address - Phone:505-414-0423
Mailing Address - Fax:
Practice Address - Street 1:4010 CARLISLE N.E
Practice Address - Street 2:SUITE F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-6929
Practice Address - Country:US
Practice Address - Phone:505-750-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-05081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1053125146Medicaid