MEDICARE: THE ZEN MONKEY MENTAL HEALTH COMPANY LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1366252520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ZEN MONKEY MENTAL HEALTH COMPANY LLC

Provider Business Mailing Address
First Line	:	1165 W BOUTZ RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3806
Country	:	US
Telephone Number	:	575-649-5131
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 TIERRA DE MESILLA STE 3A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3957
Country	:	US
Telephone Number	:	575-649-5131
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTIN ANISE KNIGHT
Credential	:	LPCC
Telephone Number	:	575-649-5131

Provider Enumeration Date	:	01/09/2025
Last Update Date	:	02/18/2025

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