Organization
PROFESSIONAL CONFIDENTIAL COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA L SWEENEY (BUSINESS MANAGER)
(505) 778-5151
Entity
Organization
Contact information
Practice address
103A SAGAR DRIVE, VANDERWAGEN, NM 87326
(505) 778-5151
(505) 778-5151
Mailing address
PO BOX 190, VANDERWAGEN, NM 87326-0190
(505) 778-5177
(505) 778-5151
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0109351
NM
101YM0800X
Mental Health Counselor
0089971
NM
101YP2500X
Professional Counselor
0086791
NM
1041C0700X
Clinical Social Worker
I-05565
NM
1041C0700X
Clinical Social Worker
I-2706
NM
Other
Enumeration date
09/15/2011
Last updated
09/16/2011
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