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General NPI Number Information
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NPI Number | 1124934021
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Entity Type | Organization
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Legal Business Name | DESERT SAGE COUNSELING & CONSULTING
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 2960 DESERT SAGE AVE SW
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City | LOS LUNAS
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State | NM
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Zip | 87031-5238
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Country | US
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Telephone | 505-750-1220
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 104
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City | BELEN
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State | NM
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Zip | 87002-0104
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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 | OWNER/MANAGING MEMBER
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Name | REBECCA KAY MIKKELSON
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Credential | CRC, LPCC
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Telephone | 505-710-8973
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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