Provider Demographics
NPI:1225045347
Name:GASKINS, NORBERT WILLIAM (PHD LPCC)
Entity Type:Individual
Prefix:DR
First Name:NORBERT
Middle Name:WILLIAM
Last Name:GASKINS
Suffix:
Gender:M
Credentials:PHD LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W SAN MIGUEL ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:NM
Mailing Address - Zip Code:88044-9411
Mailing Address - Country:US
Mailing Address - Phone:505-233-2534
Mailing Address - Fax:775-251-1216
Practice Address - Street 1:1100 S MAIN ST STE 20
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2917
Practice Address - Country:US
Practice Address - Phone:505-525-5635
Practice Address - Fax:505-647-8804
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00JM59; 00JP55OtherBCBS PROVIDER #'S