Individual
CARLOS CAMPOS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LADAC
Contact information
Practice address
100 W GRIGGS AVE, LAS CRUCES, NM 88001-1234
(575) 647-2800
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0129141
NM
104100000X
Social Worker
X-07222
NM
1041C0700X
Clinical Social Worker
Primary
C-08875
NM
Other
Enumeration date
01/26/2011
Last updated
02/24/2016
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