Provider Demographics
NPI:1851888945
Name:MAGDALENA CABIN COUNSELING
Entity Type:Organization
Organization Name:MAGDALENA CABIN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAWLCYN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:575-854-3292
Mailing Address - Street 1:AIMEE PAWLCYN
Mailing Address - Street 2:23 FRIO RD
Mailing Address - City:MAGDALENA
Mailing Address - State:NM
Mailing Address - Zip Code:87825
Mailing Address - Country:US
Mailing Address - Phone:575-854-3292
Mailing Address - Fax:
Practice Address - Street 1:MAGDALENA CABIN COUNSELING
Practice Address - Street 2:910 FIRST ST / HWY 60
Practice Address - City:MAGDALENA
Practice Address - State:NM
Practice Address - Zip Code:87825
Practice Address - Country:US
Practice Address - Phone:575-854-3292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0159361101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty