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NPI Code Detail

MEDICARE: CELESTIAL SPRINGS COUNSELING, INC.

MEDICARE: CELESTIAL SPRINGS COUNSELING, INC.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP1600XPastoral Counselor
3101YP2500XProfessional Counselor
4106H00000XMarriage & Family Therapist
5163WP0809XAdult Psychiatric/Mental Health Registered Nurse
6164W00000XLicensed Practical Nurse
7374J00000XDoula
81041C0700XClinical Social Worker

General Provider Information

NPI Number : 1801347364
Entity Type Code : Organization
Provider Name (Legal Business Name) : CELESTIAL SPRINGS COUNSELING, INC.
Provider Business Mailing Address
First Line : 12 UNSER BLVD SE
Second Line : SUITE C
City : RIO RANCHO
State : NM
Zip : 87124-6300
Country : US
Telephone Number : 575-770-0372
Fax Number :
Provider Business Practice Location Address
First Line : 12 UNSER BLVD SE
Second Line : SUITE C
City : RIO RANCHO
State : NM
Zip : 87124-6300
Country : US
Telephone Number : 575-770-0372
Fax Number :
Authorized Official
Title or Position : BOARD PRESIDENT/PSYCHOTHERAPIST
Name : DR. JOSEPH GERARD LUKAS-DROUILLARD
Credential : LCSW
Telephone Number : 419-698-1482
Provider Enumeration Date : 10/19/2016
Last Update Date : 10/19/2016

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Directions to “CELESTIAL SPRINGS COUNSELING, INC. ” Practice Location

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