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General NPI Number Information
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NPI Number | 1578602413
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Entity Type | Organization
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Legal Business Name | ACTION COUNSELING SERVICE LLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3505 RIVERSIDE
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City | ROSWELL
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State | NM
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Zip | 88201
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Country | US
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Telephone | 505-317-5101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 697 3507 RIVERSIDE DR
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City | ROSWELL
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State | NM
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Zip | 88202
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Country | US
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Telephone | 505-317-5101
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MR. GILBERT E JIMENEZ
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Credential | PHD LMFT LPCC
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Telephone | 505-317-5101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC005511
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT4794
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License Number State | NM
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