Healthcare Provider Details

I. General information

NPI: 1053505115
Provider Name (Legal Business Name): COUNSELING AND MEDIATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 ANTHONY DR SUITE 3B
ANTHONY NM
88021-9346
US

IV. Provider business mailing address

PO BOX 1063
LAS CRUCES NM
88004-1063
US

V. Phone/Fax

Practice location:
  • Phone: 575-805-5089
  • Fax: 575-882-1879
Mailing address:
  • Phone: 575-805-5089
  • Fax: 575-882-1879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNM

VIII. Authorized Official

Name: MS. ARCILIA HOLGUIN
Title or Position: OWNER
Credential: LPCC
Phone: 575-882-5290