Healthcare Provider Details

I. General information

NPI: 1881381705
Provider Name (Legal Business Name): NATHAN ENGELBRECHT MAC, LADAC, CCSS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 W AMADOR AVE
LAS CRUCES NM
88005-2739
US

IV. Provider business mailing address

2712 CLAUDE DOVE DR
LAS CRUCES NM
88011-4504
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-9681
  • Fax: 575-652-3785
Mailing address:
  • Phone: 575-313-3283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2026-0415
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTB-2024-0674
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: