Healthcare Provider Details

I. General information

NPI: 1407698921
Provider Name (Legal Business Name): SEQUOIA COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N COCHITI AVE
FARMINGTON NM
87401-4237
US

IV. Provider business mailing address

PO BOX 322
FARMINGTON NM
87499-0322
US

V. Phone/Fax

Practice location:
  • Phone: 505-613-6909
  • Fax:
Mailing address:
  • Phone: 505-613-6909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KENNETH DODSON
Title or Position: EXECUTIVE DIRECTOR
Credential: LADAC, LCSW
Phone: 505-801-2515