Healthcare Provider Details

I. General information

NPI: 1285861633
Provider Name (Legal Business Name): LA PAZ COUNSELING & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 E LOHMAN AVE
LAS CRUCES NM
88001-3172
US

IV. Provider business mailing address

PO BOX 443
ORGAN NM
88052-0443
US

V. Phone/Fax

Practice location:
  • Phone: 575-993-9048
  • Fax: 575-382-5079
Mailing address:
  • Phone: 575-993-9048
  • Fax: 575-382-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: NANCY W OLIVAS
Title or Position: ADMINISTRATOR/COUNSELOR
Credential: MA/LPCC/LADAC
Phone: 575-993-9048