Healthcare Provider Details

I. General information

NPI: 1659598597
Provider Name (Legal Business Name): NAMASTE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 MAIN ST NE STE A
LOS LUNAS NM
87031-6353
US

IV. Provider business mailing address

PO BOX 270
PERALTA NM
87042-0270
US

V. Phone/Fax

Practice location:
  • Phone: 505-865-6176
  • Fax: 505-865-3268
Mailing address:
  • Phone: 505-865-6176
  • Fax: 505-865-3268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0099741
License Number StateNM

VIII. Authorized Official

Name: CAROL REINHART
Title or Position: LPCC, EXECUTIVE DIRECTOR
Credential:
Phone: 505-865-6176