Provider Demographics
NPI:1033797923
Name:ABEYTA, MARIAH (LMHC)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:ABEYTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:HOLMAN
Mailing Address - State:NM
Mailing Address - Zip Code:87723-0185
Mailing Address - Country:US
Mailing Address - Phone:505-617-0895
Mailing Address - Fax:
Practice Address - Street 1:2514 CARMEAN DR APT 17
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4945
Practice Address - Country:US
Practice Address - Phone:505-617-0895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0212191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health