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NPI Code Detail

MEDICARE: MR. SEAN LEONARD MONAGHAN M.A.

MEDICARE: MR. SEAN LEONARD MONAGHAN M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor0096011NM

General Provider Information

NPI Number : 1053436352
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SEAN LEONARD MONAGHAN M.A.
Provider Business Mailing Address
First Line : 3751 DEL REY BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88012-7710
Country : US
Telephone Number : 505-382-3500
Fax Number : 505-382-3071
Provider Business Practice Location Address
First Line : 3751 DEL REY BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88012-7710
Country : US
Telephone Number : 505-382-3500
Fax Number : 505-382-3071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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