Healthcare Provider Details

I. General information

NPI: 1750488722
Provider Name (Legal Business Name): JOHN FORREST SCHOOLEY PHD, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JACK F SCHOOLEY PHD, LPCC

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 LA SENDA LN NW
LOS RANCHOS NM
87107-6412
US

IV. Provider business mailing address

824 LA SENDA LN NW
LOS RANCHOS NM
87107-6412
US

V. Phone/Fax

Practice location:
  • Phone: 505-463-2596
  • Fax:
Mailing address:
  • Phone: 505-463-2596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0790
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0790
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: