Healthcare Provider Details

I. General information

NPI: 1457488686
Provider Name (Legal Business Name): MARY ELIZABETH SAWYERS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ELIZABETH LOY

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E. 10TH ST.
ALAMOGORDO NM
88310
US

IV. Provider business mailing address

1320 S. SOLANO
LAS CRUCES NM
88001
US

V. Phone/Fax

Practice location:
  • Phone: 575-437-7404
  • Fax: 575-439-2860
Mailing address:
  • Phone: 575-527-7900
  • Fax: 575-571-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number93781
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0093781
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0093781
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: