Provider Demographics
NPI:1134355951
Name:MONCIVAIS, BARBARA (LMHC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MONCIVAIS
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 1:211 W WATER ST APT 303
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-6244
Mailing Address - Country:US
Mailing Address - Phone:505-501-9126
Mailing Address - Fax:
Practice Address - Street 1:6601 VALENTINE WAY
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-7301
Practice Address - Country:US
Practice Address - Phone:505-449-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0120211101Y00000X
NMT-0121101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor