Healthcare Provider Details

I. General information

NPI: 1710254800
Provider Name (Legal Business Name): JAMES H DUMESNIL, JR. MS, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BEAUTY WAY
EL PRADO NM
87529-4405
US

IV. Provider business mailing address

5 BEAUTY WAY
EL PRADO NM
87529-4405
US

V. Phone/Fax

Practice location:
  • Phone: 575-613-2222
  • Fax:
Mailing address:
  • Phone: 575-613-2222
  • Fax: 575-751-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0114151
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: