Healthcare Provider Details

I. General information

NPI: 1114274214
Provider Name (Legal Business Name): BETTER DAYS COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MAIN ST
TRUTH OR CONSEQUENCES NM
87901-2769
US

IV. Provider business mailing address

500 MAIN ST
TRUTH OR CONSEQUENCES NM
87901-2769
US

V. Phone/Fax

Practice location:
  • Phone: 575-894-0505
  • Fax:
Mailing address:
  • Phone: 575-894-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0148031
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-07672
License Number StateNM

VIII. Authorized Official

Name: ERIN C PADULA
Title or Position: LISW
Credential: LISW
Phone: 575-740-1223