Healthcare Provider Details
I. General information
NPI: 1528382488
Provider Name (Legal Business Name): COUNSELING WITHIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2010
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1925 ASPEN DR STE101B
SANTA FE NM
87505-5459
US
IV. Provider business mailing address
1925 ASPEN DR STE101B
SANTA FE NM
87505-5459
US
V. Phone/Fax
- Phone: 505-471-0402
- Fax: 505-431-6850
- Phone: 505-471-0402
- Fax: 505-431-6850
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ELAINE
MEIZLISH
Title or Position: OWNER/CLINICAL SOCIAL WORKER
Credential: MSW
Phone: 505-471-0402