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Individual

MR. JOHN MICHAEL TOURANGEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LADAC

Contact information

Practice address
3168 STATE HIGHWAY 518, CLEVELAND, NM 87715-2003
(505) 429-0905
(575) 387-5260
Mailing address
PO BOX 7, HOLMAN, NM 87723-0007
(505) 429-0905
(505) 425-2913

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAD0203391
NM
1041C0700X
Clinical Social Worker
Primary
C-4248
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49084364
NM
Enumeration date
06/08/2016
Last updated
08/30/2022
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