Provider Demographics
NPI:1558192849
Name:VAN HORN, DAVID JAMES (LMHC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:VAN HORN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 ANDERSON PL SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4503
Mailing Address - Country:US
Mailing Address - Phone:505-803-6729
Mailing Address - Fax:
Practice Address - Street 1:6000 UPTOWN BLVD NE STE 305
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4148
Practice Address - Country:US
Practice Address - Phone:505-219-1125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0198511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health