# PROFESSIONAL CONFIDENTIAL COUNSELING SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396027272
- **Authorized official:** MRS. SANDRA L SWEENEY (BUSINESS MANAGER)
- **Authorized official phone:** (505) 778-5151

## Contact information

- **Practice address:** 103A SAGAR DRIVE, VANDERWAGEN, NM 87326
- **Practice address phone:** (505) 778-5151
- **Practice address fax:** (505) 778-5151
- **Mailing address:** PO BOX 190, VANDERWAGEN, NM 87326-0190
- **Mailing address phone:** (505) 778-5177
- **Mailing address fax:** (505) 778-5151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 0109351 | NM | Yes |
| 101YM0800X | Mental Health Counselor | 0089971 | NM | — |
| 101YP2500X | Professional Counselor | 0086791 | NM | — |
| 1041C0700X | Clinical Social Worker | I-05565 | NM | — |
| 1041C0700X | Clinical Social Worker | I-2706 | NM | — |

## Other

- **Enumeration date:** 09/15/2011
- **Last updated:** 09/16/2011