Provider Demographics
NPI:1942538038
Name:CHOULES, NANCY CAROL (LMHC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:CAROL
Last Name:CHOULES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 GARCIA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2857
Mailing Address - Country:US
Mailing Address - Phone:505-795-9223
Mailing Address - Fax:
Practice Address - Street 1:637 GARCIA ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2857
Practice Address - Country:US
Practice Address - Phone:505-795-9223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT0127411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health