Provider Demographics
NPI:1912403221
Name:KATHLEEN BASLER LMFT LLC
Entity Type:Organization
Organization Name:KATHLEEN BASLER LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-202-5675
Mailing Address - Street 1:716 EL PRADO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2968
Mailing Address - Country:US
Mailing Address - Phone:575-202-5675
Mailing Address - Fax:
Practice Address - Street 1:716 EL PRADO AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2968
Practice Address - Country:US
Practice Address - Phone:575-202-5675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0109391101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty