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NPI 1023484953

NPI 1023484953 : BETH ARMSTEAD LPCC : GRANTS, NM

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General NPI Number Information
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    NPI Number           |    1023484953
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    Entity Type          |    Individual 
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    Provider Name        |    BETH ARMSTEAD LPCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/14/2015
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    Last Update Date     |    08/14/2015
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Provider Practice Location Address
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    Address Line         |    2595 W HIGHWAY 66 
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    City                 |    GRANTS
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    State                |    NM
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    Zip                  |    87020-9626
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    Country              |    US
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    Telephone            |    505-285-5451
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 102 
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    City                 |    SAN RAFAEL
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    State                |    NM
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    Zip                  |    87051-0102
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    4476
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    License Number State |    NM
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