Healthcare Provider Details

I. General information

NPI: 1013674985
Provider Name (Legal Business Name): LITTLE ASPEN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 N. BUTLER AVE. SUITE 202
FARMINGTON NM
87401
US

IV. Provider business mailing address

3300 N BUTLER AVE STE 202
FARMINGTON NM
87401-2362
US

V. Phone/Fax

Practice location:
  • Phone: 505-497-0946
  • Fax:
Mailing address:
  • Phone: 505-497-0946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHAULA BEGAY
Title or Position: OWNER/SOLE MEMBER
Credential: LPCC
Phone: 505-497-0946