Healthcare Provider Details

I. General information

NPI: 1629713573
Provider Name (Legal Business Name): MARY ZUERCHER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 CURRY ROAD 13
CLOVIS NM
88101-9422
US

IV. Provider business mailing address

1056 CURRY ROAD 13
CLOVIS NM
88101-9422
US

V. Phone/Fax

Practice location:
  • Phone: 575-749-3554
  • Fax:
Mailing address:
  • Phone: 575-749-3554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0218641
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: