Healthcare Provider Details

I. General information

NPI: 1528338365
Provider Name (Legal Business Name): JAMES NATHANIEL HUNT PH.D., LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 03/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1482 S SAINT FRANCIS DR STE B
SANTA FE NM
87505-4098
US

IV. Provider business mailing address

2017 VALLE RIO ST
SANTA FE NM
87505-6127
US

V. Phone/Fax

Practice location:
  • Phone: 505-670-5207
  • Fax:
Mailing address:
  • Phone: 505-670-5207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0140871
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: