Healthcare Provider Details

I. General information

NPI: 1457051138
Provider Name (Legal Business Name): MERCED-LLC MERCED COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 12TH STREET,
SPRINGER NM
87747
US

IV. Provider business mailing address

PO BOX 426
SPRINGER NM
87747-0426
US

V. Phone/Fax

Practice location:
  • Phone: 505-382-4922
  • Fax:
Mailing address:
  • Phone: 505-382-4922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: VALERIE MAESTAS
Title or Position: OWNER PRACTITIONER
Credential:
Phone: 505-382-4922