# ERNESTINE TENNEFOS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ernestine Tennefos, Ernestine Tennefos
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972257855
- **Authorized official:** ERNESTINE TENNEFOS LPCC (MENTAL HEALTH COUNSELOR)
- **Authorized official phone:** (575) 791-5507

## Contact information

- **Practice address:** 930 W 17TH ST, PORTALES, NM 88130-6635
- **Practice address phone:** (575) 791-5507
- **Mailing address:** 930 W 17TH ST, PORTALES, NM 88130-6635
- **Mailing address phone:** (575) 791-5507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/09/2022
- **Last updated:** 02/09/2022