Provider Demographics
NPI:1497947519
Name:ALAMOGORDO COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ALAMOGORDO COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GILSDORF
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:575-443-6166
Mailing Address - Street 1:340 CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-7834
Mailing Address - Country:US
Mailing Address - Phone:575-443-6166
Mailing Address - Fax:575-437-0755
Practice Address - Street 1:1200 N WHITE SANDS BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6774
Practice Address - Country:US
Practice Address - Phone:575-443-6166
Practice Address - Fax:575-437-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0096281101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty