Creating Connection Counseling Services | |
255 W Hadley Ave Las Cruces NM 88005-1806 | |
(575) 915-4866 | |
(575) 993-5361 |
Full Name | Creating Connection Counseling Services |
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Speciality | Clinic/Center |
Location | 255 W Hadley Ave, Las Cruces, New Mexico |
Authorized Official Name and Position | William E Lafreniere (BILLING/CREDENTIALING) |
Authorized Official Contact | 5756350407 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Creating Connection Counseling Services 255 W Hadley Ave Las Cruces NM 88005-1806 Ph: (575) 915-4866 | Creating Connection Counseling Services 255 W Hadley Ave Las Cruces NM 88005-1806 Ph: (575) 915-4866 |
NPI Number | 1124594973 |
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Provider Enumeration Date | 10/19/2018 |
Last Update Date | 01/15/2020 |
Certification Date | 01/15/2020 |
Medicare PECOS PAC ID | 8921445867 |
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Medicare Enrollment ID | O20240327000960 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124594973 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Mark J Miller |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1942373956 PECOS PAC ID: 7315993409 Enrollment ID: I20240328000520 |
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