Provider Demographics
NPI:1467949834
Name:GUNBY, HILARY ANNE (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:HILARY
Middle Name:ANNE
Last Name:GUNBY
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 1:200 MECHEM DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-6808
Mailing Address - Country:US
Mailing Address - Phone:682-253-6271
Mailing Address - Fax:
Practice Address - Street 1:200 MECHEM DR UNIT 4
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6808
Practice Address - Country:US
Practice Address - Phone:682-253-6271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2020-10-07
Deactivation Date:2020-05-25
Deactivation Code:
Reactivation Date:2020-09-09
Provider Licenses
StateLicense IDTaxonomies
NMT-CTL0195841101YP2500X
NMCMH0201091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional