Provider Demographics
NPI:1265853303
Name:AURORA COUNSELING & MENTAL HEALTH
Entity Type:Organization
Organization Name:AURORA COUNSELING & MENTAL HEALTH
Other - Org Name:AURORA COUNSELING & MENTAL HEALTH SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHYRN
Authorized Official - Middle Name:POPE
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:505-639-8141
Mailing Address - Street 1:1233 STUTZ DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-6232
Mailing Address - Country:US
Mailing Address - Phone:505-639-8141
Mailing Address - Fax:
Practice Address - Street 1:1233 STUTZ DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-6232
Practice Address - Country:US
Practice Address - Phone:505-246-6910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-063421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty