Healthcare Provider Details

I. General information

NPI: 1437761640
Provider Name (Legal Business Name): ERYCKA MIKKAL SANCHEZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S TELSHOR BLVD STE 203T
LAS CRUCES NM
88011-8679
US

IV. Provider business mailing address

755 S TELSHOR BLVD STE 203T
LAS CRUCES NM
88011-8679
US

V. Phone/Fax

Practice location:
  • Phone: 575-647-1604
  • Fax:
Mailing address:
  • Phone: 575-647-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCMH0212761
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: