Provider Demographics
NPI:1982024105
Name:DRW BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:DRW BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:575-522-5466
Mailing Address - Street 1:1395 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5327
Mailing Address - Country:US
Mailing Address - Phone:575-522-5466
Mailing Address - Fax:575-521-8611
Practice Address - Street 1:1395 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5327
Practice Address - Country:US
Practice Address - Phone:575-522-5466
Practice Address - Fax:575-521-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-27
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0042C103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty