=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558742379
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DO NO HARM COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2015
-----------------------------------------------------
Last Update Date | 06/17/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 231 SIERRA DR SE SUITE 2
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87108-2714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-270-7599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3794
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87190-3794
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-270-7599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PROVIDER
-----------------------------------------------------
Name | JEANA MEGAN DAVIS
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 505-270-7599
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 0140881
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------