Lacayo, Joseph Marion
Lacayo, Joseph Marion is an sole proprietor health care provider with primary practice located at 513 Williams St Bldg 15 , Gallup NM 87301-4799. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lacayo, Joseph Marion can be contacted via phone (505) 722-3760.Contact Information
Primary practice address
513 Williams St Bldg 15
Gallup NM 87301-4799
Phone: (505) 722-3760
Fax: (505) 722-0723
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I-2669 | New Mexico |
Profile Details
| NPI number | 1992833024 |
|---|---|
| LBN Legal business name | Lacayo, Joseph Marion |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2007 |
| Last updated | Dec 4th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992833024 | NPPES |
| New Mexico | MEDICAID | 56825374 |
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