Healthcare Provider Details

I. General information

NPI: 1902269061
Provider Name (Legal Business Name): ANXIETY TREATMENT CENTER OF THE SOUTHWEST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 E LOHMAN AVE STE 110-204
LAS CRUCES NM
88001-3167
US

IV. Provider business mailing address

2001 E LOHMAN AVE STE 110-204
LAS CRUCES NM
88001-3167
US

V. Phone/Fax

Practice location:
  • Phone: 575-405-7992
  • Fax:
Mailing address:
  • Phone: 575-405-7992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0104991
License Number StateNM

VIII. Authorized Official

Name: SHARON STEINBORN
Title or Position: OWNER
Credential: MA
Phone: 575-405-7992