Provider Demographics
NPI:1417472051
Name:NELUMS, SAMANTHA KAY (LCSW)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:KAY
Last Name:NELUMS
Suffix:
Gender:F
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:PO BOX 50022
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87181-0022
Mailing Address - Country:US
Mailing Address - Phone:505-633-6803
Mailing Address - Fax:
Practice Address - Street 1:4588 PARADISE BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4105
Practice Address - Country:US
Practice Address - Phone:505-923-2070
Practice Address - Fax:505-998-1710
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1147791041C0700X
NMSWB-2022-1177104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical