Healthcare Provider Details

I. General information

NPI: 1063784338
Provider Name (Legal Business Name): DAVID J. GOLUMB LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2012
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W GRIGGS AVE
LAS CRUCES NM
88001-1234
US

IV. Provider business mailing address

PO BOX 1349
SILVER CITY NM
88062-1349
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-7260
  • Fax:
Mailing address:
  • Phone: 575-522-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0182371
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: