Provider Demographics
NPI:1710684154
Name:NEW MEXICO CRISIS COUNSELING LLC
Entity Type:Organization
Organization Name:NEW MEXICO CRISIS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-225-2996
Mailing Address - Street 1:2676 MARICOPA DR SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-3948
Mailing Address - Country:US
Mailing Address - Phone:505-225-2996
Mailing Address - Fax:505-213-7303
Practice Address - Street 1:2676 MARICOPA DR SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3948
Practice Address - Country:US
Practice Address - Phone:505-903-6309
Practice Address - Fax:505-672-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty