Provider Demographics
NPI:1598463739
Name:LUCERO, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LUCERO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 DARTMOUTH DR SE
Mailing Address - Street 2:UNIT D
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2261
Mailing Address - Country:US
Mailing Address - Phone:505-333-9042
Mailing Address - Fax:
Practice Address - Street 1:120 DARTMOUTH DR SE APT D
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2261
Practice Address - Country:US
Practice Address - Phone:505-750-3227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-0536104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker