Healthcare Provider Details

I. General information

NPI: 1588718563
Provider Name (Legal Business Name): ARTHUR PANARO LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 CERRILLOS RD
SANTA FE NM
87505-3373
US

IV. Provider business mailing address

501 RIO GRANDE AVE G - 5
SANTA FE NM
87501-1396
US

V. Phone/Fax

Practice location:
  • Phone: 505-438-0010
  • Fax: 505-438-6011
Mailing address:
  • Phone: 505-438-0010
  • Fax: 505-438-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2974
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: