Provider Demographics
NPI:1851465199
Name:MORALES, ANNETTE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:
Last Name:MORALES
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 1:3057 STORMY POINT DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-5001
Mailing Address - Country:US
Mailing Address - Phone:915-309-2508
Mailing Address - Fax:915-309-2508
Practice Address - Street 1:3057 STORMY POINT DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-5001
Practice Address - Country:US
Practice Address - Phone:915-309-2508
Practice Address - Fax:915-309-2508
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX403341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179618701Medicaid