Provider Demographics
NPI:1588682868
Name:MOHR, DONNA RAY (LPCC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:RAY
Last Name:MOHR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N WHITE SANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6926
Mailing Address - Country:US
Mailing Address - Phone:505-439-8288
Mailing Address - Fax:505-439-9701
Practice Address - Street 1:916 N WHITE SANDS BLVD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6926
Practice Address - Country:US
Practice Address - Phone:505-439-8288
Practice Address - Fax:505-439-9701
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4027101YP2500X
NM264167101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMB9357Medicaid