Healthcare Provider Details

I. General information

NPI: 1427828870
Provider Name (Legal Business Name): CAMERON CATES LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 GRANDE BLVD SE STE E-3
RIO RANCHO NM
87124-1799
US

IV. Provider business mailing address

6301 ALAMEDA BLVD NE UNIT 1016
ALBUQUERQUE NM
87113-2586
US

V. Phone/Fax

Practice location:
  • Phone: 505-263-9314
  • Fax:
Mailing address:
  • Phone: 505-263-9314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2024-0017
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: