Provider Demographics
NPI:1467935593
Name:APPLEGATE-AGUILAR, CASEY ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:ANN
Last Name:APPLEGATE-AGUILAR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:ANN
Other - Last Name:APPLEGATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:PECOS
Mailing Address - State:NM
Mailing Address - Zip Code:87552-0710
Mailing Address - Country:US
Mailing Address - Phone:505-426-4447
Mailing Address - Fax:
Practice Address - Street 1:199 HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:NM
Practice Address - Zip Code:87552
Practice Address - Country:US
Practice Address - Phone:505-757-6482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCSA0202941101YA0400X
NMCMH0201571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)