MEDICARE: DR. CRAIG L. PIERCE PHD

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	1244	NM
2	101YM0800X	Mental Health Counselor	1243	NM

General Provider Information

NPI Number	:	1922131127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG L. PIERCE PHD

Provider Business Mailing Address
First Line	:	2612 TEXAS ST., NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4058
Country	:	US
Telephone Number	:	505-830-1871
Fax Number	:	505-369-1121

Provider Business Practice Location Address
First Line	:	2612 TEXAS ST NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4684
Country	:	US
Telephone Number	:	505-830-1871
Fax Number	:	505-369-1121

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	02/06/2013

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