Healthcare Provider Details

I. General information

NPI: 1245079367
Provider Name (Legal Business Name): MICHELLE DUGGINS LMHC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 MANZANARES AVE E
SOCORRO NM
87801-5023
US

IV. Provider business mailing address

PO BOX 37
SOCORRO NM
87801-0037
US

V. Phone/Fax

Practice location:
  • Phone: 575-349-3020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2024-0183
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: