Individual
MS. HARRIET LUCKETT VANWYNGARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC, LMSW
Contact information
Practice address
121 WYATT DR STE 7, LAS CRUCES, NM 88005-2960
(575) 649-7753
(575) 526-7835
Mailing address
146 BLACKTAIL DEER AVE, LAS CRUCES, NM 88007-5220
(575) 649-7753
(575) 526-7835
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0337
NM
1041C0700X
Clinical Social Worker
M-1657
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B9416
—
NM
Enumeration date
11/09/2006
Last updated
05/09/2018
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