Organization
ADULT AND ADOLESCENT COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY NACIM PHD (DIRECTOR)
(915) 545-1188
Entity
Organization
Contact information
Practice address
2332 MONTANA AVE, EL PASO, TX 79903-3604
(915) 545-1188
(915) 544-9107
Mailing address
2332 MONTANA AVE, EL PASO, TX 79903-3604
(915) 545-1188
(915) 544-9107
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34562
TX
1041C0700X
Clinical Social Worker
30164
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002KX
GROUP BCBS NUMBER
TX
05
—
149971701
—
TX
Enumeration date
01/26/2007
Last updated
02/27/2024
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