Provider Demographics
NPI:1437276359
Name:BETHEL BAPTIST COUNSELING
Entity Type:Organization
Organization Name:BETHEL BAPTIST COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-437-7311
Mailing Address - Street 1:1316 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4234
Mailing Address - Country:US
Mailing Address - Phone:505-437-7311
Mailing Address - Fax:505-439-5349
Practice Address - Street 1:1316 SCENIC DR
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4234
Practice Address - Country:US
Practice Address - Phone:505-437-7311
Practice Address - Fax:505-439-5349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1870,1871251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health