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General NPI Number Information
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NPI Number | 1407698921
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Entity Type | Organization
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Legal Business Name | SEQUOIA COUNSELING INC.
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 2001 N COCHITI AVE
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City | FARMINGTON
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State | NM
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Zip | 87401-4237
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Country | US
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Telephone | 505-613-6909
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 322
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City | FARMINGTON
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State | NM
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Zip | 87499-0322
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Country | US
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Telephone | 505-613-6909
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KENNETH DODSON
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Credential | LADAC, LCSW
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Telephone | 505-801-2515
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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 |
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License Number State |
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Taxonomy #2
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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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