Healthcare Provider Details

I. General information

NPI: 1194431304
Provider Name (Legal Business Name): JOLIE KOLEEN BALDWIN PLMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WESTRIDGE RD
CARLSBAD NM
88220-3550
US

IV. Provider business mailing address

1900 WESTRIDGE RD
CARLSBAD NM
88220-3550
US

V. Phone/Fax

Practice location:
  • Phone: 575-725-5552
  • Fax: 575-725-5552
Mailing address:
  • Phone: 575-725-5552
  • Fax: 575-725-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTB-2022-0848
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2025-0620
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: