Provider Demographics
NPI:1548091192
Name:ENRIQUEZ, HILDA MIRELLA (LSAA)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:MIRELLA
Last Name:ENRIQUEZ
Suffix:
Gender:
Credentials:LSAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 PINON DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-5341
Mailing Address - Country:US
Mailing Address - Phone:575-659-9318
Mailing Address - Fax:
Practice Address - Street 1:221 E GREEN ACRES DR
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-4427
Practice Address - Country:US
Practice Address - Phone:432-245-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 106S00000X
NMCTB-2024-0585101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)