Individual
WILLIAM JACK POGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
313 W APACHE ST, FARMINGTON, NM 87401-5835
(505) 325-5321
(505) 325-6453
Mailing address
313 W APACHE ST, FARMINGTON, NM 87401-5835
(505) 325-5321
(505) 325-6453
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1607
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15483
LOVELACE HEALTH CARE
NM
01
—
23788
PRESBYTERIAN HEALTH CARE
NM
01
—
362
MESA MENTAL HEALTH
NM
01
—
65613
CIGNA HEALTH CARE
NM
01
—
850447796
SAN JUAN IPA
NM
01
—
98965
VALUE OPTIONS
NM
05
—
98965
—
NM
01
—
R64S
BLUE CROSS BLUE SHIELD
NM
05
—
VNM000690T
—
NM
Enumeration date
02/21/2006
Last updated
05/09/2023
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