Provider Demographics
NPI:1003598830
Name:SPEAR, NANCY (MSW INTERN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SPEAR
Suffix:
Gender:F
Credentials:MSW INTERN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:TIRADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 DARTMOUTH DR SE APT D
Mailing Address - Street 2:
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:505-796-5475
Practice Address - Street 1:4004 CARLISLE BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4566
Practice Address - Country:US
Practice Address - Phone:505-585-5024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-1145104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker