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Organization
CENTERPOINT CHILD & FAMILY SERVICES PC
Active
Organization
CENTERPOINT CHILD & FAMILY SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY N. CARROL MS, LPCC (PRESIDENT/OWNER)
(505) 268-3064
Entity
Organization
Contact information
Practice address
1400 BARBARA LOOP SE, SUITE D, RIO RANCHO, NM 87124-1088
(505) 268-3064
(505) 268-9390
Mailing address
3508 ELDER MEADOWS DR NE, RIO RANCHO, NM 87144-0562
(505) 268-3064
(505) 268-9390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4094
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10004123
LOVELACE HEALTH PLAN
NM
01
—
4094
STATE LICENSE NUMBER
NM
01
—
NM01JA05
BLUE CROSS
NM
05
—
Z2723
—
NM
Enumeration date
11/05/2007
Last updated
11/19/2007
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