Provider Demographics
NPI:1346734738
Name:CARO, DORA (LMHC)
Entity Type:Individual
Prefix:
First Name:DORA
Middle Name:
Last Name:CARO
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 1:385 CALLE DE ALEGRA STE A
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3423
Mailing Address - Country:US
Mailing Address - Phone:575-526-1105
Mailing Address - Fax:575-524-4266
Practice Address - Street 1:18420 S HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:NM
Practice Address - Zip Code:88044
Practice Address - Country:US
Practice Address - Phone:575-233-3830
Practice Address - Fax:575-233-4542
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-CTL0196941101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM81207221Medicaid