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General NPI Number Information
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NPI Number | 1245733583
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Entity Type | Organization
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Legal Business Name | PRACTICAL SOLUTIONS ENTERPRISES, LLC
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 501 COMMERCE WAY STE 6
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City | CLOVIS
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State | NM
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Zip | 88101-4870
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Country | US
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Telephone | 575-208-0028
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Fax | 575-680-1075
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | CLOVIS
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State | NM
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Zip | 88102-0640
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Country | US
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Telephone | 575-208-0028
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Fax | 575-680-1075
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Authorized Official
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Title or Position | OWNER
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Name | MARIO CHAVEZ
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Credential | LPCC
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Telephone | 575-208-0028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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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