Organization
SOUTHEASTERN BEHAVIORAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA ANN STEPHENSON LCSW (CO-OWNER)
(575) 714-3410
Entity
Organization
Contact information
Practice address
518 E 18TH ST # B, PORTALES, NM 88130-9268
(575) 714-3410
Mailing address
518 E 18TH ST # B, PORTALES, NM 88130-9268
(575) 714-3410
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0129911
NM
101YP2500X
Professional Counselor
Primary
I-07223
NM
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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