MEDICARE: MR. CALEB DOTSON I LMHC

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	101YM0800X	Mental Health Counselor	CTB-2025-0198	NM

General Provider Information

NPI Number	:	1255125704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CALEB DOTSON I LMHC

Provider Business Mailing Address
First Line	:	1660 OLD PECOS TRL STE A
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4779
Country	:	US
Telephone Number	:	505-548-9023
Fax Number	:	505-531-8020

Provider Business Practice Location Address
First Line	:	1660 OLD PECOS TRL STE A
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4779
Country	:	US
Telephone Number	:	505-548-9023
Fax Number	:	505-531-8020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2025
Last Update Date	:	06/11/2026

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