Healthcare Provider Details

I. General information

NPI: 1972819381
Provider Name (Legal Business Name): BARBARA L MOUNCE MS.ED.LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA L MILLER

II. Dates (important events)

Enumeration Date: 08/23/2010
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 VALVERDE ST
CARLSBAD NM
88220-2608
US

IV. Provider business mailing address

915 VALVERDE ST
CARLSBAD NM
88220-2608
US

V. Phone/Fax

Practice location:
  • Phone: 575-302-3549
  • Fax: 575-302-3549
Mailing address:
  • Phone: 575-302-3549
  • Fax: 575-302-3549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0140501
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: