Mr David L Crane, LPCC | |
102 E High St, Tucumcari, NM 88401-2726 | |
(505) 461-6200 | |
(505) 461-0404 |
Full Name | Mr David L Crane |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 102 E High St, Tucumcari, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871568410 | NPI | - | NPPES |
NM100178 | Other | NM | INDIV PROV MEDICAID |
43220380 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 006177 (New Mexico) | Primary |
Entity Name | Mesa Counseling, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518180777 PECOS PAC ID: 1355883851 Enrollment ID: O20240612002416 |
Mailing Address | Practice Location Address |
---|---|
Mr David L Crane, LPCC 102 E High St, P.o. Box 881, Tucumcari, NM 88401-2726 Ph: (505) 461-6200 | Mr David L Crane, LPCC 102 E High St, Tucumcari, NM 88401-2726 Ph: (505) 461-6200 |
Krystal R Tapia, BMS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 | |
Ethel Shaw, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E. High Street, Tucumcari, NM 88401 Phone: 575-461-4411 Fax: 575-461-4102 | |
Ann Largent, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 102 E High St, Tucumcari, NM 88401 Phone: 505-461-6200 Fax: 505-461-0404 | |
Robert Noel Poe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 | |
Ashley Ann Nolan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 | |
Jacqueline Garcia, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 Fax: 575-461-4102 | |
Vicky Laredo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 505-461-4411 |