Provider Demographics
NPI:1922399880
Name:CENTRAL NEW MEXICO COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:CENTRAL NEW MEXICO COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:505-615-0240
Mailing Address - Street 1:526 SUN RANCH VILLAGE LOOP SW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-4869
Mailing Address - Country:US
Mailing Address - Phone:505-615-0240
Mailing Address - Fax:505-869-0645
Practice Address - Street 1:526 SUN RANCH VILLAGE LOOP SW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-4869
Practice Address - Country:US
Practice Address - Phone:505-615-0240
Practice Address - Fax:505-869-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0093331251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health