Healthcare Provider Details

I. General information

NPI: 1962136176
Provider Name (Legal Business Name): DONALD POOLE LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 MONTGOMERY BLVD NE STE V
ALBUQUERQUE NM
87111-2470
US

IV. Provider business mailing address

653 W ARRINGTON ST
FARMINGTON NM
87401-8513
US

V. Phone/Fax

Practice location:
  • Phone: 505-217-1717
  • Fax:
Mailing address:
  • Phone: 505-217-1717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTB-2022-0241
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCTB20250181
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: