Provider Demographics
NPI:1144787581
Name:ALDER AND OAK COUNSELING LLC
Entity Type:Organization
Organization Name:ALDER AND OAK COUNSELING LLC
Other - Org Name:ALDER AND OAK COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:CAMERON
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-257-8554
Mailing Address - Street 1:3600 CERRILLOS RD
Mailing Address - Street 2:ST 303
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2612
Mailing Address - Country:US
Mailing Address - Phone:505-257-8554
Mailing Address - Fax:505-930-7813
Practice Address - Street 1:3600 CERRILLOS RD STE 303
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2694
Practice Address - Country:US
Practice Address - Phone:505-257-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty