MEDICARE: SOUTHWEST COUNSELING CENTER

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
1	302F00000X	Exclusive Provider Organization	4314	NM

General Provider Information

NPI Number	:	1205855970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST COUNSELING CENTER

Provider Business Mailing Address
First Line	:	1902 WESTWIND RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-5575
Country	:	US
Telephone Number	:	505-524-4392
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 S DOWNTOWN MALL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-1218
Country	:	US
Telephone Number	:	505-647-2824
Fax Number	:	505-647-2895

Authorized Official
Title or Position	:	LICENSED DRUG/ALCOHOL COUNSELOR
Name	:	MRS. EMILY JEAN PAREDES
Credential	:	LADAC
Telephone Number	:	505-647-2824

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/22/2020

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