Provider Demographics
NPI:1841609401
Name:BEYOND ENVISIONING, LLC
Entity Type:Organization
Organization Name:BEYOND ENVISIONING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:SNYDER
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:575-571-1345
Mailing Address - Street 1:755 S TELSHOR BLVD
Mailing Address - Street 2:UNIT R201
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4688
Mailing Address - Country:US
Mailing Address - Phone:575-571-1345
Mailing Address - Fax:
Practice Address - Street 1:755 S TELSHOR BLVD
Practice Address - Street 2:UNIT R201
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4688
Practice Address - Country:US
Practice Address - Phone:575-571-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NM0141291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty