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General NPI Number Information
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NPI Number | 1619273711
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Entity Type | Individual
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Provider Name | ABIGAIL L MITCHELL'LOCKWOOD LPCC
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Gender | Female
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 340 CAMINO REAL
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City | ALAMOGORDO
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State | NM
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Zip | 88310-7834
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Country | US
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Telephone | 575-443-6166
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Fax | 575-437-0755
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Provider Business Mailing Address
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Address Line | 1200 N WHITE SANDS BLVD # 111
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City | ALAMOGORDO
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State | NM
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Zip | 88310-6774
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Country | US
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Telephone | 575-443-6166
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Fax | 575-437-0755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0149931
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.007702
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License Number State | IL
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