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NPI Code Detail

MEDICARE: ANN BODEN LPCC

MEDICARE: ANN BODEN LPCC
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
1101YM0800XMental Health CounselorLH61588618WA

General Provider Information

NPI Number : 1295164671
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN BODEN LPCC
Provider Business Mailing Address
First Line : PO BOX 370
Second Line :
City : HATCH
State : NM
Zip : 87937-0370
Country : US
Telephone Number : 575-267-3280
Fax Number : 575-267-1747
Provider Business Practice Location Address
First Line : 1955 N VALLEY DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-5154
Country : US
Telephone Number : 575-523-2772
Fax Number : 575-524-2993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2013
Last Update Date : 10/16/2025

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Directions to “ ANN BODEN LPCC” Practice Location

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