Healthcare Provider Details

I. General information

NPI: 1346697026
Provider Name (Legal Business Name): MARY E. SAWYERS, MA, LPCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N WHITE SANDS BLVD STE 118
ALAMOGORDO NM
88310-6774
US

IV. Provider business mailing address

1617 ROSALIA LN
ALAMOGORDO NM
88310-6313
US

V. Phone/Fax

Practice location:
  • Phone: 575-415-9270
  • Fax: 208-978-7050
Mailing address:
  • Phone: 575-415-9270
  • Fax: 120-897-8705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0093781
License Number StateNM

VIII. Authorized Official

Name: MARY ELIZABETH SAWYERS
Title or Position: LPCC
Credential: MA
Phone: 575-415-9270