=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821417171
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHIELA KAY WEEHUNT LPCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2014
-----------------------------------------------------
Last Update Date | 02/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2474 INDIAN WELLS RD
-----------------------------------------------------
City | ALAMOGORDO
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88310-3845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-430-4804
-----------------------------------------------------
Fax | 575-439-9701
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 148
-----------------------------------------------------
City | LA LUZ
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88337-0148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-430-4804
-----------------------------------------------------
Fax | 575-439-9701
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 0184131
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------