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Organization

LIFE CHANGES COUNSELING & CONSULTING, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CARLTON D LEWIS LCMHC (PRESIDENT/COUNSELOR)
(575) 693-8230
Entity
Organization

Contact information

Practice address
2300 N MAIN ST STE 29, CLOVIS, NM 88101-3575
(575) 693-8230
Mailing address
2701 PUTNAM DR, CLOVIS, NM 88101-9351
(575) 693-8230

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0106271
NM
251S00000X
Community/Behavioral Health Agency
0125231
NM
251S00000X
Community/Behavioral Health Agency
I-06845
NM
251S00000X
Community/Behavioral Health Agency
M-07179
NM

Other

Enumeration date
08/11/2011
Last updated
08/11/2011
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