Healthcare Provider Details

I. General information

NPI: 1053084152
Provider Name (Legal Business Name): CATALPA COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 4TH ST NW STE E3
LOS RANCHOS NM
87107-5800
US

IV. Provider business mailing address

6501 4TH ST NW STE E3
LOS RANCHOS NM
87107-5800
US

V. Phone/Fax

Practice location:
  • Phone: 505-600-2243
  • Fax: 866-530-3317
Mailing address:
  • Phone: 505-600-2243
  • Fax: 866-530-3317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES DION HAMEL
Title or Position: THERAPIST
Credential: LCSW
Phone: 505-600-2243