Healthcare Provider Details

I. General information

NPI: 1902243991
Provider Name (Legal Business Name): CHARLENE I. DOBBINS LPCC, LADAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BARBARA LOOP SE STE C
RIO RANCHO NM
87124-1088
US

IV. Provider business mailing address

184 UNSER BLVD NE
RIO RANCHO NM
87124-4045
US

V. Phone/Fax

Practice location:
  • Phone: 505-750-0405
  • Fax:
Mailing address:
  • Phone: 505-962-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCCMH0192731
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAD0179511
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0192731
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: