Healthcare Provider Details

I. General information

NPI: 1447909841
Provider Name (Legal Business Name): CHAPARRAL COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 MIGUEL CHAVEZ RD
SANTA FE NM
87505-6914
US

IV. Provider business mailing address

PO BOX 477
CERRILLOS NM
87010-0477
US

V. Phone/Fax

Practice location:
  • Phone: 562-508-6353
  • Fax:
Mailing address:
  • Phone: 562-508-6353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH BARNARD
Title or Position: LCSW
Credential:
Phone: 562-508-6353