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1619723426

NPI Code Detail

MEDICARE: SOUTHWEST THERAPEUTICS LLC

MEDICARE: SOUTHWEST THERAPEUTICS 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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	163WP0200X	Pediatric Registered Nurse
3	171M00000X	Case Manager/Care Coordinator
4	261QM0855X	Adolescent and Children Mental Health Clinic/Center
5	163WP0808X	Psychiatric/Mental Health Registered Nurse
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
7	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse
8	261QM0850X	Adult Mental Health Clinic/Center
9	103TC1900X	Counseling Psychologist
10	207QA0401X	Addiction Medicine (Family Medicine) Physician
11	1041C0700X	Clinical Social Worker
12	101YP2500X	Professional Counselor
13	2080P0006X	Developmental - Behavioral Pediatrics Physician
14	207Q00000X	Family Medicine Physician
15	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1619723426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST THERAPEUTICS LLC

Provider Business Mailing Address
First Line	:	PO BOX 1280
Second Line	:
City	:	DEMING
State	:	NM
Zip	:	88031-1280
Country	:	US
Telephone Number	:	575-936-4350
Fax Number	:	575-936-4351

Provider Business Practice Location Address
First Line	:	1419 S SANTA BARBARA ST
Second Line	:
City	:	DEMING
State	:	NM
Zip	:	88030-5361
Country	:	US
Telephone Number	:	575-936-4350
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE ADMINISTRATOR
Name	:	ARACELI DURAN
Credential	:
Telephone Number	:	575-936-4350

Provider Enumeration Date	:	04/24/2024
Last Update Date	:	09/04/2025

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Directions to “SOUTHWEST THERAPEUTICS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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