Healthcare Provider Details

I. General information

NPI: 1235041864
Provider Name (Legal Business Name): MS. ANGELA PENNINGTON-HOWEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5231 COMANCHE TRL
LAS CRUCES NM
88012-7362
US

IV. Provider business mailing address

5231 COMANCHE TRL
LAS CRUCES NM
88012-7362
US

V. Phone/Fax

Practice location:
  • Phone: 575-319-3167
  • Fax:
Mailing address:
  • Phone: 575-312-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTB-2026-0817
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: