Provider Demographics
NPI:1790087617
Name:HARBORS COUNSELING LLC
Entity Type:Organization
Organization Name:HARBORS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERLEY
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:575-586-2404
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:QUESTA
Mailing Address - State:NM
Mailing Address - Zip Code:87556-0144
Mailing Address - Country:US
Mailing Address - Phone:575-586-2404
Mailing Address - Fax:575-586-1549
Practice Address - Street 1:81 CABRESTO ROAD
Practice Address - Street 2:
Practice Address - City:QUESTA
Practice Address - State:NM
Practice Address - Zip Code:87556
Practice Address - Country:US
Practice Address - Phone:575-586-2404
Practice Address - Fax:575-586-1549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1021251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health