Provider Demographics
NPI:1558571653
Name:BASLER, KATHY CECELIA (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:CECELIA
Last Name:BASLER
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 1:715 E IDAHO AVE STE 2E
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-4701
Mailing Address - Country:US
Mailing Address - Phone:575-556-9585
Mailing Address - Fax:575-556-9456
Practice Address - Street 1:715 E IDAHO AVE STE 2E
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-4701
Practice Address - Country:US
Practice Address - Phone:575-556-9585
Practice Address - Fax:575-556-9456
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0088041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health