Provider Demographics
NPI:1598114068
Name:CAMINO NUEVO COUNSELING
Entity Type:Organization
Organization Name:CAMINO NUEVO COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORIEGA-AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-222-0657
Mailing Address - Street 1:1308 KEARNY PL
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-8129
Mailing Address - Country:US
Mailing Address - Phone:575-222-0657
Mailing Address - Fax:575-222-0659
Practice Address - Street 1:1570 W PICACHO AVE STE 2
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2375
Practice Address - Country:US
Practice Address - Phone:575-222-0657
Practice Address - Fax:575-222-0659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM18677037Medicaid