Healthcare Provider Details

I. General information

NPI: 1689930133
Provider Name (Legal Business Name): OSCAR ARTIAGA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 ST ANTHONY ST SERENITY COUNSELING
ANTHONY NM
88021
US

IV. Provider business mailing address

4664 CAPLES CIR
EL PASO TX
79903-1533
US

V. Phone/Fax

Practice location:
  • Phone: 575-805-4234
  • Fax:
Mailing address:
  • Phone: 915-922-8108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberT-0145411
License Number StateNM

VIII. Authorized Official

Name: MR. OSCAR ARTIAGA I
Title or Position: THERAPIST
Credential: LMHC
Phone: 915-922-8108