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General NPI Number Information
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NPI Number | 1982405478
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Entity Type | Organization
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Legal Business Name | NIGHTJAR LLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 112 ALEXANDER ST # D2
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City | TAOS
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State | NM
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Zip | 87571-6841
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Country | US
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Telephone | 575-770-2151
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | RANCHOS DE TAOS
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State | NM
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Zip | 87557-0297
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Country | US
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Telephone | 575-770-2151
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | NATALIE CHRISTINE PAYNTER
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Credential | MA, LPCC
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Telephone | 575-770-2151
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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 |
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License Number State |
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