Organization
MANZANO MOUNTAIN COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIND GUMAER LISW,LCSW (AUTHORIZED AGENT)
(518) 755-3758
Entity
Organization
Contact information
Practice address
1011 ALLEN AVENUE WEST, ESTANCIA, NM 87016
(505) 818-7881
Mailing address
HC 66 BOX 335, MOUNTAINAIR, NM 87036-9605
(505) 818-7881
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C-09413
NM
101YM0800X
Mental Health Counselor
I-08197
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111575365
SOLUTIONS, A BRIEF THERAPY CENTER LLC
NY
01
—
1861738924
VALENCIA COUNSELING
NM
Enumeration date
10/17/2017
Last updated
06/16/2018
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