Healthcare Provider Details

I. General information

NPI: 1891794731
Provider Name (Legal Business Name): CARLSBAD MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 N CANAL ST
CARLSBAD NM
88220-5110
US

IV. Provider business mailing address

914 N CANAL ST
CARLSBAD NM
88220-5110
US

V. Phone/Fax

Practice location:
  • Phone: 505-885-4836
  • Fax: 505-887-9579
Mailing address:
  • Phone: 505-885-4836
  • Fax: 505-887-9579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3045
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3045
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3045
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3045
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3045
License Number StateNM

VIII. Authorized Official

Name: MR. NOEL CLARK
Title or Position: CEO
Credential: LPCC
Phone: 505-887-4626