Provider Demographics
NPI:1467263863
Name:MELVIN G ANAYA
Entity type:Organization
Organization Name:MELVIN G ANAYA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ANAYA
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:575-317-5571
Mailing Address - Street 1:PO BOX 8075
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88202-8075
Mailing Address - Country:US
Mailing Address - Phone:575-317-5571
Mailing Address - Fax:
Practice Address - Street 1:201B E 2ND ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-6211
Practice Address - Country:US
Practice Address - Phone:575-317-5571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty