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General NPI Number Information
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NPI Number | 1588521579
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Entity Type | Organization
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Legal Business Name | CARLSBAD LIFEHOUSE INC
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 2324 W PIERCE ST
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City | CARLSBAD
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State | NM
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Zip | 88220-3514
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Country | US
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Telephone | 575-725-5552
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Fax | 575-725-5552
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Provider Business Mailing Address
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Address Line | PO BOX 3141
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City | CARLSBAD
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State | NM
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Zip | 88221-3141
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Country | US
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Telephone | 575-725-5552
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Fax | 575-725-5552
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Authorized Official
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Title or Position | CREDENTIALING
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Name | TIFFINEY FITZGERALD
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Credential |
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Telephone | 575-725-5552
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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 | 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 #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #8
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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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