MEDICARE: DESERT SKY COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073702551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT SKY COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	205 W BOUTZ RD
Second Line	:	BLDG. 8 STE. 1
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3262
Country	:	US
Telephone Number	:	575-521-4555
Fax Number	:	575-521-1169

Provider Business Practice Location Address
First Line	:	205 W BOUTZ RD
Second Line	:	BLDG. 8 SUITE 1
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3262
Country	:	US
Telephone Number	:	575-521-4555
Fax Number	:	575-521-1169

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE R LYNCH
Credential	:	PMHNP
Telephone Number	:	575-521-4555

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	10/09/2013

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Directions to “DESERT SKY COUNSELING SERVICES LLC ” Practice Location

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