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Contact Information

LATARA ANDERSON, LCSW
2105 HASLER VALLEY RD
GALLUP, NM87301
 Phone: 505-413-3447
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for LATARA ANDERSON · (Female)

NPI Number 1255088563
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 03/07/2022
Last updated 07/16/2025 - About 11 months ago
Sole proprietor 1 Yes
Identifiers
  • FL License # SW19622
  • NM License # SWB-2025-0420
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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