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General NPI Number Information
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NPI Number | 1063348712
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Entity Type | Organization
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Legal Business Name | BEACON THERAPY SERVICES LLC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 715 E IDAHO AVE ST 2B
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City | LAS CRUCES
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State | NM
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Zip | 88001
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Country | US
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Telephone | 575-448-1503
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Fax |
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Provider Business Mailing Address
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Address Line | 715 E IDAHO AVE ST 2B
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City | LAS CRUCES
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State | NM
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Zip | 88001
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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 | FOUNDER
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Name | MADISON J DURAN
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Credential | LCSW, RPT
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Telephone | 575-448-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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