Healthcare Provider Details

I. General information

NPI: 1992449524
Provider Name (Legal Business Name): WILLIAM SKY HITT LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 BROTHERS RD STE B
SANTA FE NM
87505-6975
US

IV. Provider business mailing address

130 RIDGECREST DR
SANTA FE NM
87505-6335
US

V. Phone/Fax

Practice location:
  • Phone: 505-699-3681
  • Fax:
Mailing address:
  • Phone: 505-699-3681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCMH0214891
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: