Provider Demographics
NPI:1609467455
Name:GUIDED COURAGE, LLC
Entity Type:Organization
Organization Name:GUIDED COURAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC, NCC
Authorized Official - Phone:505-278-0050
Mailing Address - Street 1:PO BOX 15402
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87174-0402
Mailing Address - Country:US
Mailing Address - Phone:505-278-0050
Mailing Address - Fax:
Practice Address - Street 1:504 GRAL TREVINO DR SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1202
Practice Address - Country:US
Practice Address - Phone:505-278-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty