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General NPI Number Information
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NPI Number | 1003226671
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Entity Type | Organization
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Legal Business Name | BARBARA BIRDSONG, LPCC, LLC
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 700 MECHEM DR STE 7
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City | RUIDOSO
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State | NM
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Zip | 88345-6900
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Country | US
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Telephone | 575-937-8483
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Fax | 575-258-3320
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Provider Business Mailing Address
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Address Line | 102 PAMELA LN
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City | RUIDOSO
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State | NM
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Zip | 88345-9322
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Country | US
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Telephone | 575-937-8483
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Fax | 575-258-3320
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | BARBARA BIRDSONG
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Credential | LPCC
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Telephone | 575-937-8483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4845005
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License Number State | NM
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