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NPI Code Detail

MEDICARE: ELBA DANIEL LPCC

MEDICARE: ELBA DANIEL 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 CounselorCCMH0209311NM

Other Identifiers

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

General Provider Information

NPI Number : 1689125908
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELBA DANIEL LPCC
Provider Business Mailing Address
First Line : 304 W GRIGGS AVE STE 20
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-2603
Country : US
Telephone Number : 915-238-6926
Fax Number :
Provider Business Practice Location Address
First Line : 304 W GRIGGS AVE STE 20
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-2603
Country : US
Telephone Number : 915-238-6926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2016
Last Update Date : 05/30/2024

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Directions to “ ELBA DANIEL LPCC” Practice Location

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