Healthcare Provider Details

I. General information

NPI: 1841998820
Provider Name (Legal Business Name): ACCOUNTABLE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 ARROYO HONDO RD
SANTA FE NM
87508-5941
US

IV. Provider business mailing address

132 ARROYO HONDO RD
SANTA FE NM
87508-5941
US

V. Phone/Fax

Practice location:
  • Phone: 971-261-8737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. TOR TRAVIS
Title or Position: OWNER
Credential: LCSW
Phone: 971-261-8737