Individual
KELLI MATAJCICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P-LMHC
Contact information
Practice address
2110 SULLIVAN AVE, FARMINGTON, NM 87401-4324
(505) 578-7563
Mailing address
2110 SULLIVAN AVE, FARMINGTON, NM 87401-4324
(505) 578-7563
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2025-0012
NM
101YM0800X
Mental Health Counselor
Primary
CTB-2025-0466
NM
Other
Enumeration date
02/14/2025
Last updated
03/19/2026
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