Wayne Favreau, LPCC | |
1302 Calle De La Merced, Espanola, NM 87532-2624 | |
(505) 747-0081 | |
Not Available |
Full Name | Wayne Favreau |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 1302 Calle De La Merced, Espanola, 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 |
---|---|---|---|
1730278854 | NPI | - | NPPES |
XXXXXXX | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 0100411 (New Mexico) | Secondary |
101YP2500X | Counselor - Professional | 0100411 (New Mexico) | Primary |
Entity Name | United Counseling Service Of Bennington County Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427104132 PECOS PAC ID: 0648226167 Enrollment ID: O20050329000156 |
Mailing Address | Practice Location Address |
---|---|
Wayne Favreau, LPCC 2551 Coors Blvd Nw, Albuquerque, NM 87120-1213 Ph: (505) 338-3320 | Wayne Favreau, LPCC 1302 Calle De La Merced, Espanola, NM 87532-2624 Ph: (505) 747-0081 |
Cassie Garcia, BMS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1305 Calle De La Merced, Espanola, NM 87532 Phone: 505-747-0081 | |
Simon M Johnson, BMS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1302 Calle De La Merced, Suite H, Espanola, NM 87532 Phone: 505-747-0081 | |
Leann A Murray, BMS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1302 Calle De La Merced, Suite H, Espanola, NM 87532 Phone: 505-747-0081 | |
Peter H Goodwin, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1114 Plaza Del Norte, Suite B, Espanola, NM 87532 Phone: 505-753-8933 Fax: 505-753-9811 | |
Ashley Lopez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1302 Calle De La Merced, Espanola, NM 87532 Phone: 505-747-0081 | |
Sara E Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1206 N Riverside Dr, Espanola, NM 87532 Phone: 505-747-7400 | |
Christopher Alcala, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1302 Calle De La Merced, Espanola, NM 87532 Phone: 505-747-0081 |