Provider Demographics
NPI:1750488722
Name:SCHOOLEY, JOHN FORREST (PHD, LPCC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FORREST
Last Name:SCHOOLEY
Suffix:
Gender:M
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:JACK
Other - Middle Name:F
Other - Last Name:SCHOOLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LPCC
Mailing Address - Street 1:824 LA SENDA LN NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6412
Mailing Address - Country:US
Mailing Address - Phone:505-463-2596
Mailing Address - Fax:
Practice Address - Street 1:824 LA SENDA LN NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-6412
Practice Address - Country:US
Practice Address - Phone:505-463-2596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0790101Y00000X
NMCCMH0790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00JN03OtherBLUE CROSS BLUE SHIELD
NM15602OtherLOVELACE
NM000Z6642Medicaid
NM201034357OtherPRESBYTHERIAN
NMNM100973OtherVALUE OPTION
NM0000Z6642Medicaid