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Individual

MARCOS PENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LADAC

Contact information

Practice address
1301 COUNTRY CLUB RD, SANTA TERESA, NM 88008-9431
(575) 332-4070
(833) 428-3821
Mailing address
1301 COUNTRY CLUB RD, SANTA TERESA, NM 88008-9431
(915) 248-7067

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CTB-2023-0281
NM
1041C0700X
Clinical Social Worker
Primary
103362
TX
1041C0700X
Clinical Social Worker
SWB-2023-0579
NM

Other

Enumeration date
06/04/2020
Last updated
05/11/2026
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